- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,546.00 / $15,294.20 / $26,759.10
| Facility | | $11,546.00 | $15,294.20 | $26,759.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,985.44 / $13,204.02 / $19,131.88
| Facility | | $11,985.44 | $13,204.02 | $19,131.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.91 / $13,307.00 / $26,265.71
| Facility | | $5,843.91 | $13,307.00 | $26,265.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,593.20 / $15,533.61 / $23,891.18
| Facility | | $10,593.20 | $15,533.61 | $23,891.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $15,761.42 / $24,073.62
| Facility | | $3,496.00 | $15,761.42 | $24,073.62 |