- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,796.00 / $14,300.80 / $25,021.00
| Facility | | $10,796.00 | $14,300.80 | $25,021.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,414.24 / $11,754.11 / $15,623.89
| Facility | | $9,414.24 | $11,754.11 | $15,623.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $12,256.28 / $25,055.99
| Facility | | $5,843.91 | $12,256.28 | $25,055.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,244.51 / $14,524.64 / $22,339.35
| Facility | | $10,244.51 | $14,524.64 | $22,339.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $14,737.65 / $22,509.94
| Facility | | $3,496.00 | $14,737.65 | $22,509.94 |