- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,270.69 / $16,104.50 / $26,737.30
| Facility | | $11,270.69 | $16,104.50 | $26,737.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,792.51 / $13,459.93 / $22,460.21
| Facility | | $8,792.51 | $13,459.93 | $22,460.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,799.00 / $17,177.29 / $24,698.85
| Facility | | $13,799.00 | $17,177.29 | $24,698.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,629.37 / $17,244.93 / $39,316.62
| Facility | | $8,629.37 | $17,244.93 | $39,316.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,629.37 / $16,464.84 / $23,140.53
| Facility | | $8,629.37 | $16,464.84 | $23,140.53 |