- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,028.20 / $19,952.70 / $26,775.00
| Facility | | $12,028.20 | $19,952.70 | $26,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,798.79 / $25,798.79 / $25,798.79
| Facility | | $25,798.79 | $25,798.79 | $25,798.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,178.95 / $17,336.22 / $27,738.62
| Facility | | $10,178.95 | $17,336.22 | $27,738.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,876.76 / $16,065.00 / $36,843.47
| Facility | | $9,876.76 | $16,065.00 | $36,843.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,726.38 / $15,825.10 / $22,418.17
| Facility | | $11,726.38 | $15,825.10 | $22,418.17 |