- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,797.00 / $18,687.40 / $24,561.70
| Facility | | $12,797.00 | $18,687.40 | $24,561.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,151.14 / $19,475.24 / $32,939.75
| Facility | | $7,151.14 | $19,475.24 | $32,939.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,999.97 / $18,770.43 / $31,417.46
| Facility | | $12,999.97 | $18,770.43 | $31,417.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,096.85 / $20,948.05 / $30,585.86
| Facility | | $16,096.85 | $20,948.05 | $30,585.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,096.85 / $19,474.00 / $30,585.86
| Facility | | $16,096.85 | $19,474.00 | $30,585.86 |