- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,105.20 / $20,342.00 / $28,802.10
| Facility | | $11,105.20 | $20,342.00 | $28,802.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,757.58 / $17,195.65 / $27,065.40
| Facility | | $10,757.58 | $17,195.65 | $27,065.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,546.04 / $18,298.72 / $32,556.33
| Facility | | $11,546.04 | $18,298.72 | $32,556.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $16,554.16 / $38,497.93
| Facility | | $7,117.00 | $16,554.16 | $38,497.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $16,888.71 / $34,211.26
| Facility | | $3,308.00 | $16,888.71 | $34,211.26 |