- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,537.84 / $16,618.90 / $27,591.30
| Facility | | $12,537.84 | $16,618.90 | $27,591.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,178.64 / $15,581.88 / $26,335.68
| Facility | | $10,178.64 | $15,581.88 | $26,335.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,981.35 / $16,926.62 / $25,487.73
| Facility | | $12,981.35 | $16,926.62 | $25,487.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $17,795.75 / $45,514.85
| Facility | | $8,787.00 | $17,795.75 | $45,514.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,905.00 / $16,990.74 / $23,879.65
| Facility | | $8,905.00 | $16,990.74 | $23,879.65 |