- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,348.50 / $18,956.00 / $26,839.60
| Facility | | $10,348.50 | $18,956.00 | $26,839.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,419.93 / $18,647.21 / $30,089.75
| Facility | | $11,419.93 | $18,647.21 | $30,089.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,759.32 / $17,051.89 / $30,338.02
| Facility | | $10,759.32 | $17,051.89 | $30,338.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,846.84 / $16,305.24 / $35,874.76
| Facility | | $6,846.84 | $16,305.24 | $35,874.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,737.95 / $31,880.19
| Facility | | $3,308.00 | $15,737.95 | $31,880.19 |