- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,027.10 / $20,199.00 / $28,599.60
| Facility | | $11,027.10 | $20,199.00 | $28,599.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,368.80 / $18,434.07 / $29,636.40
| Facility | | $11,368.80 | $18,434.07 | $29,636.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,464.86 / $18,170.07 / $32,327.43
| Facility | | $11,464.86 | $18,170.07 | $32,327.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $16,410.09 / $38,227.25
| Facility | | $7,117.00 | $16,410.09 | $38,227.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,769.96 / $33,970.73
| Facility | | $3,308.00 | $16,769.96 | $33,970.73 |