- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,896.20 / $22,013.30 / $35,780.90
| Facility | | $12,896.20 | $22,013.30 | $35,780.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $16,757.41 / $21,407.00
| Facility | | $11,258.00 | $16,757.41 | $21,407.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,058.41 / $17,490.66 / $27,593.23
| Facility | | $11,058.41 | $17,490.66 | $27,593.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,196.54 / $18,502.50 / $34,436.98
| Facility | | $10,196.54 | $18,502.50 | $34,436.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $18,523.64 / $25,128.05
| Facility | | $6,289.00 | $18,523.64 | $25,128.05 |