- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,390.10 / $17,631.70 / $19,953.00
| Facility | | $11,390.10 | $17,631.70 | $19,953.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,367.80 / $17,193.47 / $23,221.08
| Facility | | $11,367.80 | $17,193.47 | $23,221.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,510.81 / $15,468.02 / $22,117.67
| Facility | | $10,510.81 | $15,468.02 | $22,117.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,200.70 / $16,699.29 / $21,132.00
| Facility | | $10,200.70 | $16,699.29 | $21,132.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $20,377.41 / $27,120.69
| Facility | | $5,274.00 | $20,377.41 | $27,120.69 |