- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,548.79 / $12,467.00 / $20,237.90
| Facility | | $8,548.79 | $12,467.00 | $20,237.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,874.72 / $21,146.63 / $27,111.06
| Facility | | $14,874.72 | $21,146.63 | $27,111.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,038.29 / $19,408.11 / $24,547.75
| Facility | | $10,038.29 | $19,408.11 | $24,547.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,919.25 / $13,407.40 / $21,439.00
| Facility | | $8,919.25 | $13,407.40 | $21,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,430.95 / $17,837.07 / $27,099.70
| Facility | | $10,430.95 | $17,837.07 | $27,099.70 |