- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,658.63 / $15,225.00 / $24,514.20
| Facility | | $6,658.63 | $15,225.00 | $24,514.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $7,811.88 / $20,437.32
| Facility | | $1,474.01 | $7,811.88 | $20,437.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,020.93 / $15,918.69 / $22,550.74
| Facility | | $11,020.93 | $15,918.69 | $22,550.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.86 / $13,026.11 / $27,575.10
| Facility | | $9,044.86 | $13,026.11 | $27,575.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.86 / $13,351.45 / $28,401.73
| Facility | | $9,044.86 | $13,351.45 | $28,401.73 |