- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,543.58 / $17,481.50 / $24,752.00
| Facility | | $9,543.58 | $17,481.50 | $24,752.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,248.78 / $16,434.11 / $25,824.63
| Facility | | $10,248.78 | $16,434.11 | $25,824.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,922.44 / $15,725.56 / $27,978.27
| Facility | | $9,922.44 | $15,725.56 | $27,978.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,314.28 / $14,837.05 / $33,084.36
| Facility | | $6,314.28 | $14,837.05 | $33,084.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,513.82 / $29,400.49
| Facility | | $3,308.00 | $14,513.82 | $29,400.49 |