- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $11,527.90 / $18,827.09
| Facility | | $6,303.00 | $11,527.90 | $18,827.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,225.76 / $20,940.65 / $28,097.83
| Facility | | $15,225.76 | $20,940.65 | $28,097.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,474.85 / $17,131.28 / $24,015.24
| Facility | | $12,474.85 | $17,131.28 | $24,015.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,860.48 / $19,026.20 / $23,985.82
| Facility | | $10,860.48 | $19,026.20 | $23,985.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,860.48 / $19,184.59 / $25,156.72
| Facility | | $10,860.48 | $19,184.59 | $25,156.72 |