- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,952.30 / $16,238.20 / $24,748.00
| Facility | | $11,952.30 | $16,238.20 | $24,748.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,542.71 / $14,997.53 / $21,743.16
| Facility | | $9,542.71 | $14,997.53 | $21,743.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,426.81 / $14,394.84 / $26,054.00
| Facility | | $10,426.81 | $14,394.84 | $26,054.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.83 / $152.66 / $243.31
| Facility | | $110.83 | $152.66 | $243.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,484.60 / $15,894.24 / $26,158.22
| Facility | | $11,484.60 | $15,894.24 | $26,158.22 |