- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,254.00 / $19,549.70 / $34,840.00
| Facility | | $5,254.00 | $19,549.70 | $34,840.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $17,430.03 / $24,655.04
| Facility | | $11,231.00 | $17,430.03 | $24,655.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,871.15 / $16,709.61 / $28,763.22
| Facility | | $10,871.15 | $16,709.61 | $28,763.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,043.81 / $15,845.22 / $29,427.13
| Facility | | $8,043.81 | $15,845.22 | $29,427.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.00 / $19,015.68 / $30,461.00
| Facility | | $6,553.00 | $19,015.68 | $30,461.00 |