- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,726.90 / $19,649.00 / $27,820.90
| Facility | | $10,726.90 | $19,649.00 | $27,820.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,665.63 / $19,034.84 / $30,814.71
| Facility | | $11,665.63 | $19,034.84 | $30,814.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,152.68 / $17,675.31 / $31,447.18
| Facility | | $11,152.68 | $17,675.31 | $31,447.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,097.16 / $15,781.04 / $37,186.35
| Facility | | $7,097.16 | $15,781.04 | $37,186.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,520.00 / $17,146.40 / $37,026.00
| Facility | | $6,520.00 | $17,146.40 | $37,026.00 |