- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,379.70 / $21,533.00 / $21,533.00
| Facility | | $19,379.70 | $21,533.00 | $21,533.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,540.36 / $20,297.39 / $32,175.56
| Facility | | $10,540.36 | $20,297.39 | $32,175.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,625.04 / $14,715.86 / $35,262.51
| Facility | | $9,625.04 | $14,715.86 | $35,262.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,799.64 / $24,308.97 / $37,259.66
| Facility | | $17,799.64 | $24,308.97 | $37,259.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $32,169.82 / $41,536.62
| Facility | | $6,965.00 | $32,169.82 | $41,536.62 |