- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,132.00 / $14,795.70 / $21,417.30
| Facility | | $10,132.00 | $14,795.70 | $21,417.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,637.03 / $12,628.38 / $21,359.20
| Facility | | $4,637.03 | $12,628.38 | $21,359.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,292.68 / $14,861.42 / $24,874.65
| Facility | | $10,292.68 | $14,861.42 | $24,874.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,744.62 / $16,585.54 / $24,216.24
| Facility | | $12,744.62 | $16,585.54 | $24,216.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,744.62 / $15,418.47 / $24,216.24
| Facility | | $12,744.62 | $15,418.47 | $24,216.24 |