- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,879.90 / $17,498.40 / $27,552.40
| Facility | | $12,879.90 | $17,498.40 | $27,552.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,485.07 / $16,001.38 / $23,428.54
| Facility | | $10,485.07 | $16,001.38 | $23,428.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,236.02 / $15,760.46 / $30,361.00
| Facility | | $11,236.02 | $15,760.46 | $30,361.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.43 / $164.51 / $262.19
| Facility | | $119.43 | $164.51 | $262.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,375.90 / $17,127.75 / $28,188.30
| Facility | | $12,375.90 | $17,127.75 | $28,188.30 |