- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $10,774.90 / $17,597.30
| Facility | | $6,303.00 | $10,774.90 | $17,597.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,231.17 / $19,572.74 / $26,262.39
| Facility | | $14,231.17 | $19,572.74 | $26,262.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,659.95 / $16,012.21 / $22,446.49
| Facility | | $11,659.95 | $16,012.21 | $22,446.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,151.04 / $17,783.34 / $22,418.99
| Facility | | $10,151.04 | $17,783.34 | $22,418.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,151.04 / $17,931.39 / $23,513.40
| Facility | | $10,151.04 | $17,931.39 | $23,513.40 |