- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,508.30 / $16,993.50 / $25,164.00
| Facility | | $12,508.30 | $16,993.50 | $25,164.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,178.87 / $15,534.11 / $22,744.38
| Facility | | $10,178.87 | $15,534.11 | $22,744.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,911.85 / $15,064.47 / $27,266.00
| Facility | | $10,911.85 | $15,064.47 | $27,266.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.99 / $159.77 / $254.62
| Facility | | $115.99 | $159.77 | $254.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,018.85 / $16,633.62 / $27,375.06
| Facility | | $12,018.85 | $16,633.62 | $27,375.06 |