- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,424.31 / $17,664.00 / $29,326.40
| Facility | | $11,424.31 | $17,664.00 | $29,326.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,443.32 / $13,741.01 / $25,514.40
| Facility | | $9,443.32 | $13,741.01 | $25,514.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,712.00 / $17,991.07 / $26,977.52
| Facility | | $13,712.00 | $17,991.07 | $26,977.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,465.00 / $18,914.86 / $30,321.32
| Facility | | $9,465.00 | $18,914.86 | $30,321.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $18,512.03 / $25,381.34
| Facility | | $9,226.00 | $18,512.03 | $25,381.34 |