- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $12,756.90 / $20,834.09
| Facility | | $6,303.00 | $12,756.90 | $20,834.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,848.87 / $23,172.98 / $31,093.14
| Facility | | $16,848.87 | $23,172.98 | $31,093.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,804.70 / $18,957.52 / $26,575.33
| Facility | | $13,804.70 | $18,957.52 | $26,575.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,018.24 / $21,054.45 / $26,542.78
| Facility | | $12,018.24 | $21,054.45 | $26,542.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,018.24 / $21,229.72 / $27,838.50
| Facility | | $12,018.24 | $21,229.72 | $27,838.50 |