- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,092.46 / $16,649.00 / $27,108.80
| Facility | | $8,092.46 | $16,649.00 | $27,108.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,786.32 / $26,393.68 / $34,224.47
| Facility | | $17,786.32 | $26,393.68 | $34,224.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,647.00 / $21,755.18 / $34,784.24
| Facility | | $14,647.00 | $21,755.18 | $34,784.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,196.91 / $23,436.65 / $49,147.40
| Facility | | $12,196.91 | $23,436.65 | $49,147.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,206.03 / $23,281.89 / $34,792.82
| Facility | | $17,206.03 | $23,281.89 | $34,792.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,822.40 / $17,332.00 / $31,835.45
| Facility | | $7,822.40 | $17,332.00 | $31,835.45 |