- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,229.50 / $22,582.30 / $36,705.69
| Facility | | $13,229.50 | $22,582.30 | $36,705.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,640.00 / $15,484.61 / $27,930.63
| Facility | | $9,640.00 | $15,484.61 | $27,930.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,344.25 / $17,942.75 / $28,306.44
| Facility | | $11,344.25 | $17,942.75 | $28,306.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,380.28 / $16,921.04 / $31,581.73
| Facility | | $9,380.28 | $16,921.04 | $31,581.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,322.22 / $18,757.00 / $25,777.55
| Facility | | $6,322.22 | $18,757.00 | $25,777.55 |