- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,588.00 / $15,461.60 / $20,321.80
| Facility | | $10,588.00 | $15,461.60 | $20,321.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,494.42 / $9,516.62 / $16,096.10
| Facility | | $3,494.42 | $9,516.62 | $16,096.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,755.92 / $15,530.28 / $25,994.18
| Facility | | $10,755.92 | $15,530.28 | $25,994.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,318.21 / $17,332.00 / $25,306.13
| Facility | | $13,318.21 | $17,332.00 | $25,306.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,267.42 / $16,678.30 / $24,040.73
| Facility | | $11,267.42 | $16,678.30 | $24,040.73 |