- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,056.10 / $14,056.00 / $22,817.30
| Facility | | $10,056.10 | $14,056.00 | $22,817.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,564.76 / $33,500.82 / $42,949.77
| Facility | | $23,564.76 | $33,500.82 | $42,949.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,317.75 / $21,881.80 / $27,676.52
| Facility | | $11,317.75 | $21,881.80 | $27,676.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,056.10 / $15,116.20 / $24,171.50
| Facility | | $10,056.10 | $15,116.20 | $24,171.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,760.45 / $20,110.52 / $30,553.73
| Facility | | $11,760.45 | $20,110.52 | $30,553.73 |