- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,907.40 / $18,093.50 / $24,280.00
| Facility | | $10,907.40 | $18,093.50 | $24,280.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,529.60 / $10,846.59 / $14,001.08
| Facility | | $10,529.60 | $10,846.59 | $14,001.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,618.12 / $15,010.91 / $23,210.46
| Facility | | $8,618.12 | $15,010.91 | $23,210.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,956.41 / $14,568.00 / $33,410.25
| Facility | | $8,956.41 | $14,568.00 | $33,410.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,633.67 / $14,096.97 / $20,159.20
| Facility | | $10,633.67 | $14,096.97 | $20,159.20 |