- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,588.20 / $17,938.30 / $20,300.09
| Facility | | $11,588.20 | $17,938.30 | $20,300.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,442.48 / $17,306.41 / $23,802.74
| Facility | | $11,442.48 | $17,306.41 | $23,802.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,700.86 / $16,907.05 / $25,211.99
| Facility | | $10,700.86 | $16,907.05 | $25,211.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,398.84 / $18,859.00 / $26,741.00
| Facility | | $13,398.84 | $18,859.00 | $26,741.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,245.00 / $15,460.03 / $27,506.44
| Facility | | $7,245.00 | $15,460.03 | $27,506.44 |