- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,162.00 / $19,220.40 / $25,262.30
| Facility | | $13,162.00 | $19,220.40 | $25,262.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,876.24 / $13,279.85 / $22,461.08
| Facility | | $4,876.24 | $13,279.85 | $22,461.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,370.79 / $19,305.84 / $32,313.63
| Facility | | $13,370.79 | $19,305.84 | $32,313.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,556.00 / $21,545.58 / $31,458.30
| Facility | | $16,556.00 | $21,545.58 | $31,458.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,556.00 / $20,029.49 / $31,458.30
| Facility | | $16,556.00 | $20,029.49 | $31,458.30 |