- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,118.00 / $11,838.80 / $19,218.00
| Facility | | $8,118.00 | $11,838.80 | $19,218.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,534.73 / $27,771.54 / $35,604.54
| Facility | | $19,534.73 | $27,771.54 | $35,604.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,532.44 / $18,430.08 / $23,310.72
| Facility | | $9,532.44 | $18,430.08 | $23,310.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,469.78 / $12,731.70 / $20,358.59
| Facility | | $8,469.78 | $12,731.70 | $20,358.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,905.31 / $16,938.21 / $25,734.06
| Facility | | $9,905.31 | $16,938.21 | $25,734.06 |