- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,685.30 / $13,850.10 / $27,025.00
| Facility | | $10,685.30 | $13,850.10 | $27,025.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,449.23 / $12,449.23 / $22,274.48
| Facility | | $12,449.23 | $12,449.23 | $22,274.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,661.06 / $12,974.78 / $21,979.54
| Facility | | $8,661.06 | $12,974.78 | $21,979.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,926.05 / $15,124.05 / $22,566.00
| Facility | | $11,926.05 | $15,124.05 | $22,566.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $14,632.96 / $29,232.00
| Facility | | $8,787.00 | $14,632.96 | $29,232.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.75 / $14,145.44 / $19,880.71
| Facility | | $7,413.75 | $14,145.44 | $19,880.71 |