- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,330.10 / $17,135.90 / $22,995.00
| Facility | | $10,330.10 | $17,135.90 | $22,995.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,151.04 / $9,151.04 / $9,151.04
| Facility | | $9,151.04 | $9,151.04 | $9,151.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,254.70 / $14,109.09 / $22,294.82
| Facility | | $8,254.70 | $14,109.09 | $22,294.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,482.40 / $13,797.00 / $31,642.04
| Facility | | $8,482.40 | $13,797.00 | $31,642.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,011.10 / $13,590.96 / $19,490.56
| Facility | | $10,011.10 | $13,590.96 | $19,490.56 |