- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,507.30 / $18,308.50 / $30,791.00
| Facility | | $10,507.30 | $18,308.50 | $30,791.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,665.61 / $14,876.30 / $19,668.30
| Facility | | $10,665.61 | $14,876.30 | $19,668.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,475.46 / $13,405.32 / $21,148.19
| Facility | | $8,475.46 | $13,405.32 | $21,148.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,803.85 / $12,054.26 / $22,765.57
| Facility | | $6,803.85 | $12,054.26 | $22,765.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,505.00 / $14,197.01 / $19,258.81
| Facility | | $6,505.00 | $14,197.01 | $19,258.81 |