- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,923.40 / $16,917.00 / $19,648.00
| Facility | | $10,923.40 | $16,917.00 | $19,648.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,057.94 / $16,724.82 / $22,588.13
| Facility | | $11,057.94 | $16,724.82 | $22,588.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,086.95 / $15,565.25 / $21,211.41
| Facility | | $10,086.95 | $15,565.25 | $21,211.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,319.00 / $17,802.00 / $21,565.00
| Facility | | $13,319.00 | $17,802.00 | $21,565.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,542.45 / $25,946.96
| Facility | | $5,274.00 | $19,542.45 | $25,946.96 |