- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,961.30 / $18,182.90 / $24,400.00
| Facility | | $10,961.30 | $18,182.90 | $24,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,958.09 / $14,932.48 / $21,678.30
| Facility | | $10,958.09 | $14,932.48 | $21,678.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,308.87 / $15,619.77 / $23,820.32
| Facility | | $9,308.87 | $15,619.77 | $23,820.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,000.67 / $14,640.00 / $33,575.37
| Facility | | $9,000.67 | $14,640.00 | $33,575.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,686.22 / $14,421.38 / $20,429.63
| Facility | | $10,686.22 | $14,421.38 | $20,429.63 |