- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,553.00 / $16,532.80 / $28,988.20
| Facility | | $10,553.00 | $16,532.80 | $28,988.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,465.22 / $19,955.46 / $22,882.49
| Facility | | $11,465.22 | $19,955.46 | $22,882.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,446.49 / $14,596.79 / $20,557.12
| Facility | | $7,446.49 | $14,596.79 | $20,557.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,100.00 / $14,445.32 / $25,310.12
| Facility | | $9,100.00 | $14,445.32 | $25,310.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,244.00 / $15,976.89 / $22,402.31
| Facility | | $10,244.00 | $15,976.89 | $22,402.31 |