- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,306.40 / $12,113.50 / $19,664.00
| Facility | | $8,306.40 | $12,113.50 | $19,664.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,264.20 / $20,278.70 / $25,998.33
| Facility | | $14,264.20 | $20,278.70 | $25,998.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,753.67 / $18,857.80 / $23,851.70
| Facility | | $9,753.67 | $18,857.80 | $23,851.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,666.34 / $13,027.20 / $20,831.09
| Facility | | $8,666.34 | $13,027.20 | $20,831.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,135.19 / $17,331.30 / $26,331.29
| Facility | | $10,135.19 | $17,331.30 | $26,331.29 |