- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,798.77 / $17,949.00 / $25,413.80
| Facility | | $9,798.77 | $17,949.00 | $25,413.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,401.32 / $16,792.31 / $26,530.04
| Facility | | $10,401.32 | $16,792.31 | $26,530.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,187.76 / $16,146.06 / $28,726.40
| Facility | | $10,187.76 | $16,146.06 | $28,726.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,483.12 / $15,378.16 / $33,969.01
| Facility | | $6,483.12 | $15,378.16 | $33,969.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,901.91 / $30,186.64
| Facility | | $3,308.00 | $14,901.91 | $30,186.64 |