- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,175.00 / $15,714.70 / $37,078.00
| Facility | | $10,175.00 | $15,714.70 | $37,078.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,717.52 / $14,875.98 / $24,660.58
| Facility | | $9,717.52 | $14,875.98 | $24,660.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,262.49 / $15,989.29 / $24,076.32
| Facility | | $12,262.49 | $15,989.29 | $24,076.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,411.87 / $16,084.85 / $43,452.92
| Facility | | $8,411.87 | $16,084.85 | $43,452.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,411.87 / $16,049.86 / $22,557.28
| Facility | | $8,411.87 | $16,049.86 | $22,557.28 |