- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,483.28 / $17,371.09 / $24,595.60
| Facility | | $9,483.28 | $17,371.09 | $24,595.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,574.09 / $15,205.87 / $24,163.84
| Facility | | $9,574.09 | $15,205.87 | $24,163.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,859.74 / $15,626.19 / $27,801.48
| Facility | | $9,859.74 | $15,626.19 | $27,801.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,486.00 / $14,378.00 / $30,347.13
| Facility | | $5,486.00 | $14,378.00 | $30,347.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,163.00 / $13,951.53 / $27,568.45
| Facility | | $4,163.00 | $13,951.53 | $27,568.45 |