- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,488.00 / $21,043.20 / $29,794.90
| Facility | | $11,488.00 | $21,043.20 | $29,794.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,072.84 / $19,580.16 / $31,491.50
| Facility | | $12,072.84 | $19,580.16 | $31,491.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,944.02 / $18,929.46 / $33,678.51
| Facility | | $11,944.02 | $18,929.46 | $33,678.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $17,401.43 / $39,824.91
| Facility | | $7,117.00 | $17,401.43 | $39,824.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $17,470.84 / $35,390.49
| Facility | | $3,308.00 | $17,470.84 | $35,390.49 |