- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,070.00 / $20,232.09 / $22,895.90
| Facility | | $13,070.00 | $20,232.09 | $22,895.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,289.57 / $18,587.63 / $25,564.88
| Facility | | $12,289.57 | $18,587.63 | $25,564.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,061.04 / $18,624.07 / $28,435.93
| Facility | | $12,061.04 | $18,624.07 | $28,435.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,948.12 / $19,639.00 / $26,741.00
| Facility | | $11,948.12 | $19,639.00 | $26,741.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $18,877.49 / $31,045.96
| Facility | | $5,274.00 | $18,877.49 | $31,045.96 |