- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,698.00 / $18,651.80 / $47,486.00
| Facility | | $5,698.00 | $18,651.80 | $47,486.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,251.54 / $15,122.49 / $33,594.23
| Facility | | $8,251.54 | $15,122.49 | $33,594.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,284.58 / $17,144.40 / $29,705.71
| Facility | | $10,284.58 | $17,144.40 | $29,705.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,319.00 / $21,056.36 / $32,274.22
| Facility | | $14,319.00 | $21,056.36 | $32,274.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,107.24 / $23,656.70 / $35,959.64
| Facility | | $9,107.24 | $23,656.70 | $35,959.64 |