- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,008.20 / $16,314.20 / $24,453.00
| Facility | | $12,008.20 | $16,314.20 | $24,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,775.61 / $15,066.59 / $21,843.28
| Facility | | $9,775.61 | $15,066.59 | $21,843.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,475.64 / $14,462.24 / $26,176.00
| Facility | | $10,475.64 | $14,462.24 | $26,176.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.35 / $153.38 / $244.44
| Facility | | $111.35 | $153.38 | $244.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,538.38 / $15,968.67 / $26,280.70
| Facility | | $11,538.38 | $15,968.67 | $26,280.70 |