- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,465.20 / $17,863.70 / $29,036.00
| Facility | | $10,465.20 | $17,863.70 | $29,036.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,177.00 / $14,630.28 / $19,489.59
| Facility | | $11,177.00 | $14,630.28 | $19,489.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,973.84 / $14,193.58 / $22,391.74
| Facility | | $8,973.84 | $14,193.58 | $22,391.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,413.81 / $10,841.46 / $22,582.87
| Facility | | $5,413.81 | $10,841.46 | $22,582.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $15,031.82 / $20,391.27
| Facility | | $6,289.00 | $15,031.82 | $20,391.27 |