- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,416.62 / $17,249.00 / $24,422.70
| Facility | | $9,416.62 | $17,249.00 | $24,422.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.25 / $17,480.31 / $27,447.18
| Facility | | $10,964.25 | $17,480.31 | $27,447.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,790.44 / $15,516.36 / $27,606.07
| Facility | | $9,790.44 | $15,516.36 | $27,606.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,230.28 / $15,483.90 / $32,644.23
| Facility | | $6,230.28 | $15,483.90 | $32,644.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,320.74 / $29,009.37
| Facility | | $3,308.00 | $14,320.74 | $29,009.37 |