- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,810.70 / $23,574.40 / $38,318.30
| Facility | | $13,810.70 | $23,574.40 | $38,318.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,947.66 / $15,762.00 / $21,608.87
| Facility | | $10,947.66 | $15,762.00 | $21,608.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,842.62 / $18,731.02 / $29,549.99
| Facility | | $11,842.62 | $18,731.02 | $29,549.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,079.54 / $18,604.33 / $35,429.44
| Facility | | $10,079.54 | $18,604.33 | $35,429.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,505.00 / $19,563.50 / $26,910.00
| Facility | | $6,505.00 | $19,563.50 | $26,910.00 |