- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,065.00 / $17,535.70 / $29,113.30
| Facility | | $11,065.00 | $17,535.70 | $29,113.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,056.93 / $15,395.56 / $25,521.90
| Facility | | $10,056.93 | $15,395.56 | $25,521.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,115.18 / $18,703.80 / $26,893.78
| Facility | | $15,115.18 | $18,703.80 | $26,893.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,036.94 / $17,967.13 / $44,970.60
| Facility | | $9,036.94 | $17,967.13 | $44,970.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $17,928.05 / $25,196.98
| Facility | | $9,226.00 | $17,928.05 | $25,196.98 |