- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,304.30 / $19,082.00 / $31,454.30
| Facility | | $11,304.30 | $19,082.00 | $31,454.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,553.65 / $14,797.44 / $18,906.43
| Facility | | $9,553.65 | $14,797.44 | $18,906.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,118.32 / $14,422.10 / $22,752.26
| Facility | | $9,118.32 | $14,422.10 | $22,752.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,416.71 / $13,226.80 / $24,492.32
| Facility | | $7,416.71 | $13,226.80 | $24,492.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $15,273.84 / $20,719.58
| Facility | | $6,289.00 | $15,273.84 | $20,719.58 |