- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,602.80 / $17,685.09 / $26,362.00
| Facility | | $12,602.80 | $17,685.09 | $26,362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,261.03 / $15,659.47 / $22,927.93
| Facility | | $10,261.03 | $15,659.47 | $22,927.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,994.29 / $15,421.41 / $27,472.00
| Facility | | $10,994.29 | $15,421.41 | $27,472.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.86 / $160.97 / $256.55
| Facility | | $116.86 | $160.97 | $256.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,109.66 / $16,759.29 / $27,581.89
| Facility | | $12,109.66 | $16,759.29 | $27,581.89 |