- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,860.79 / $16,832.00 / $27,359.10
| Facility | | $9,860.79 | $16,832.00 | $27,359.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,353.96 / $18,960.34 / $19,352.58
| Facility | | $12,353.96 | $18,960.34 | $19,352.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,455.57 / $13,373.86 / $21,098.55
| Facility | | $8,455.57 | $13,373.86 | $21,098.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,839.37 / $14,496.52 / $28,165.06
| Facility | | $7,839.37 | $14,496.52 | $28,165.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $14,163.69 / $19,213.61
| Facility | | $6,289.00 | $14,163.69 | $19,213.61 |