- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,345.33 / $15,737.10 / $26,127.30
| Facility | | $10,345.33 | $15,737.10 | $26,127.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,426.24 / $15,960.91 / $26,459.11
| Facility | | $10,426.24 | $15,960.91 | $26,459.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,854.00 / $16,070.32 / $25,040.00
| Facility | | $12,854.00 | $16,070.32 | $25,040.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,432.50 / $16,124.29 / $46,622.01
| Facility | | $8,432.50 | $16,124.29 | $46,622.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,432.50 / $16,089.21 / $22,612.59
| Facility | | $8,432.50 | $16,089.21 | $22,612.59 |