- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,374.73 / $17,172.20 / $24,314.00
| Facility | | $9,374.73 | $17,172.20 | $24,314.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,679.36 / $17,242.93 / $27,634.40
| Facility | | $10,679.36 | $17,242.93 | $27,634.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,746.87 / $15,447.33 / $27,483.25
| Facility | | $9,746.87 | $15,447.33 | $27,483.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,202.56 / $14,574.54 / $32,498.99
| Facility | | $6,202.56 | $14,574.54 | $32,498.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,257.03 / $28,880.30
| Facility | | $3,308.00 | $14,257.03 | $28,880.30 |