- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,081.80 / $18,711.00 / $21,164.70
| Facility | | $12,081.80 | $18,711.00 | $21,164.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,198.18 / $18,449.39 / $25,374.75
| Facility | | $12,198.18 | $18,449.39 | $25,374.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,156.63 / $17,215.87 / $26,285.83
| Facility | | $11,156.63 | $17,215.87 | $26,285.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,431.82 / $18,649.00 / $25,651.00
| Facility | | $11,431.82 | $18,649.00 | $25,651.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $15,941.03 / $28,698.51
| Facility | | $4,008.00 | $15,941.03 | $28,698.51 |