- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,908.68 / $16,210.00 / $26,344.00
| Facility | | $9,908.68 | $16,210.00 | $26,344.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,598.93 / $14,518.10 / $19,607.80
| Facility | | $9,598.93 | $14,518.10 | $19,607.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,774.42 / $13,539.85 / $20,673.15
| Facility | | $8,774.42 | $13,539.85 | $20,673.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,127.00 / $15,277.00 / $19,893.00
| Facility | | $10,127.00 | $15,277.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,126.88 / $22,625.00
| Facility | | $5,274.00 | $17,126.88 | $22,625.00 |