- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,582.80 / $19,385.00 / $27,447.10
| Facility | | $10,582.80 | $19,385.00 | $27,447.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,163.95 / $19,484.66 / $32,234.81
| Facility | | $12,163.95 | $19,484.66 | $32,234.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,002.86 / $17,437.87 / $31,024.73
| Facility | | $11,002.86 | $17,437.87 | $31,024.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,001.82 / $16,924.20 / $36,686.80
| Facility | | $7,001.82 | $16,924.20 | $36,686.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,094.18 / $32,601.81
| Facility | | $3,308.00 | $16,094.18 | $32,601.81 |