- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,841.50 / $14,361.00 / $25,126.30
| Facility | | $10,841.50 | $14,361.00 | $25,126.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,512.22 / $10,720.15 / $19,469.66
| Facility | | $6,512.22 | $10,720.15 | $19,469.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $11,676.77 / $23,492.88
| Facility | | $5,843.91 | $11,676.77 | $23,492.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,884.56 / $14,585.79 / $22,433.40
| Facility | | $9,884.56 | $14,585.79 | $22,433.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,799.70 / $22,469.20
| Facility | | $3,496.00 | $14,799.70 | $22,469.20 |