- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,187.40 / $14,856.60 / $24,117.00
| Facility | | $10,187.40 | $14,856.60 | $24,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,097.53 / $35,679.89 / $45,743.45
| Facility | | $25,097.53 | $35,679.89 | $45,743.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,962.40 / $23,128.18 / $29,252.97
| Facility | | $11,962.40 | $23,128.18 | $29,252.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,628.90 / $15,977.20 / $25,548.30
| Facility | | $10,628.90 | $15,977.20 | $25,548.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,430.33 / $21,256.01 / $32,294.06
| Facility | | $12,430.33 | $21,256.01 | $32,294.06 |