- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,726.80 / $17,548.40 / $26,013.00
| Facility | | $10,726.80 | $17,548.40 | $26,013.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,274.37 / $15,539.70 / $20,987.54
| Facility | | $10,274.37 | $15,539.70 | $20,987.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,498.90 / $14,657.81 / $21,899.00
| Facility | | $9,498.90 | $14,657.81 | $21,899.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,727.00 / $15,541.21 / $20,329.00
| Facility | | $10,727.00 | $15,541.21 | $20,329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,029.32 / $24,434.27
| Facility | | $5,274.00 | $15,029.32 | $24,434.27 |