- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,426.10 / $21,210.90 / $34,476.60
| Facility | | $12,426.10 | $21,210.90 | $34,476.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $15,573.43 / $24,871.07
| Facility | | $11,258.00 | $15,573.43 | $24,871.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,655.32 / $16,853.11 / $26,587.41
| Facility | | $10,655.32 | $16,853.11 | $26,587.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,049.56 / $12,610.32 / $26,814.36
| Facility | | $6,049.56 | $12,610.32 | $26,814.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $17,848.41 / $24,212.10
| Facility | | $6,289.00 | $17,848.41 | $24,212.10 |