- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,505.40 / $17,810.09 / $20,155.00
| Facility | | $11,505.40 | $17,810.09 | $20,155.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,824.79 / $17,884.65 / $24,154.57
| Facility | | $11,824.79 | $17,884.65 | $24,154.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,624.38 / $15,866.00 / $22,341.52
| Facility | | $10,624.38 | $15,866.00 | $22,341.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,633.00 / $17,862.00 / $21,488.00
| Facility | | $11,633.00 | $17,862.00 | $21,488.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $20,583.64 / $27,395.17
| Facility | | $5,274.00 | $20,583.64 | $27,395.17 |