- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,787.51 / $14,384.20 / $22,208.00
| Facility | | $9,787.51 | $14,384.20 | $22,208.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,848.74 / $21,109.69 / $27,063.71
| Facility | | $14,848.74 | $21,109.69 | $27,063.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,015.50 / $21,297.43 / $26,937.40
| Facility | | $11,015.50 | $21,297.43 | $26,937.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,787.51 / $14,712.50 / $23,526.00
| Facility | | $9,787.51 | $14,712.50 | $23,526.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,446.38 / $19,573.46 / $29,737.77
| Facility | | $11,446.38 | $19,573.46 | $29,737.77 |