- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,836.30 / $23,513.00 / $33,291.90
| Facility | | $12,836.30 | $23,513.00 | $33,291.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,723.08 / $23,790.76 / $37,843.83
| Facility | | $14,723.08 | $23,790.76 | $37,843.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,345.86 / $18,937.00 / $37,631.28
| Facility | | $13,345.86 | $18,937.00 | $37,631.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $18,884.39 / $44,499.06
| Facility | | $7,117.00 | $18,884.39 | $44,499.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,520.00 / $20,460.22 / $41,077.00
| Facility | | $6,520.00 | $20,460.22 | $41,077.00 |