- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,362.60 / $22,809.50 / $37,075.00
| Facility | | $13,362.60 | $22,809.50 | $37,075.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,640.00 / $19,620.22 / $22,614.35
| Facility | | $9,640.00 | $19,620.22 | $22,614.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,458.37 / $18,123.25 / $28,591.20
| Facility | | $11,458.37 | $18,123.25 | $28,591.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,608.48 / $16,559.20 / $30,719.00
| Facility | | $8,608.48 | $16,559.20 | $30,719.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,385.82 / $18,928.74 / $26,036.87
| Facility | | $6,385.82 | $18,928.74 | $26,036.87 |