- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,332.20 / $20,806.00 / $27,920.00
| Facility | | $11,332.20 | $20,806.00 | $27,920.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,432.37 / $14,426.28 / $17,685.72
| Facility | | $9,432.37 | $14,426.28 | $17,685.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,821.44 / $16,487.63 / $25,653.08
| Facility | | $8,821.44 | $16,487.63 | $25,653.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,299.12 / $16,752.00 / $38,419.04
| Facility | | $10,299.12 | $16,752.00 | $38,419.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,640.87 / $15,994.81 / $23,181.42
| Facility | | $10,640.87 | $15,994.81 | $23,181.42 |