- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,743.75 / $15,090.10 / $17,069.00
| Facility | | $9,743.75 | $15,090.10 | $17,069.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,818.51 / $14,850.21 / $20,424.54
| Facility | | $9,818.51 | $14,850.21 | $20,424.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,997.65 / $14,216.03 / $21,199.11
| Facility | | $8,997.65 | $14,216.03 | $21,199.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,553.00 / $16,761.32 / $25,651.00
| Facility | | $10,553.00 | $16,761.32 | $25,651.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $14,073.25 / $23,144.90
| Facility | | $5,274.00 | $14,073.25 | $23,144.90 |