- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,436.00 / $15,337.30 / $23,679.50
| Facility | | $10,436.00 | $15,337.30 | $23,679.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,100.18 / $31,418.70 / $40,280.39
| Facility | | $22,100.18 | $31,418.70 | $40,280.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,745.40 / $22,708.64 / $28,722.32
| Facility | | $11,745.40 | $22,708.64 | $28,722.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,436.00 / $15,687.40 / $25,084.90
| Facility | | $10,436.00 | $15,687.40 | $25,084.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,991.29 / $20,870.41 / $31,708.24
| Facility | | $12,991.29 | $20,870.41 | $31,708.24 |