- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,545.30 / $19,151.59 / $25,700.00
| Facility | | $11,545.30 | $19,151.59 | $25,700.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,037.17 / $14,037.17 / $16,902.89
| Facility | | $14,037.17 | $14,037.17 | $16,902.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,474.27 / $16,564.89 / $26,504.46
| Facility | | $9,474.27 | $16,564.89 | $26,504.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,480.21 / $15,420.00 / $35,364.23
| Facility | | $9,480.21 | $15,420.00 | $35,364.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,255.57 / $15,189.73 / $21,518.10
| Facility | | $11,255.57 | $15,189.73 | $21,518.10 |