- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,003.37 / $16,492.00 / $23,350.90
| Facility | | $9,003.37 | $16,492.00 | $23,350.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,774.40 / $13,930.37 / $22,059.16
| Facility | | $8,774.40 | $13,930.37 | $22,059.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,360.78 / $14,835.42 / $26,394.56
| Facility | | $9,360.78 | $14,835.42 | $26,394.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,956.86 / $13,179.51 / $31,211.62
| Facility | | $5,956.86 | $13,179.51 | $31,211.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,692.27 / $27,736.27
| Facility | | $3,308.00 | $13,692.27 | $27,736.27 |