- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,556.12 / $16,543.09 / $27,465.40
| Facility | | $11,556.12 | $16,543.09 | $27,465.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,681.45 / $13,256.57 / $22,405.57
| Facility | | $8,681.45 | $13,256.57 | $22,405.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,701.00 / $17,645.07 / $25,265.60
| Facility | | $13,701.00 | $17,645.07 | $25,265.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $16,950.09 / $38,722.61
| Facility | | $8,787.00 | $16,950.09 | $38,722.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,864.37 / $16,913.23 / $23,770.71
| Facility | | $8,864.37 | $16,913.23 | $23,770.71 |