- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $11,084.70 / $18,103.20
| Facility | | $6,303.00 | $11,084.70 | $18,103.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,640.31 / $20,135.45 / $27,017.43
| Facility | | $14,640.31 | $20,135.45 | $27,017.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,995.17 / $16,472.56 / $23,091.82
| Facility | | $11,995.17 | $16,472.56 | $23,091.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,442.87 / $18,294.62 / $23,063.54
| Facility | | $10,442.87 | $18,294.62 | $23,063.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,442.87 / $18,446.91 / $24,189.41
| Facility | | $10,442.87 | $18,446.91 | $24,189.41 |