- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,897.34 / $13,076.00 / $20,188.09
| Facility | | $8,897.34 | $13,076.00 | $20,188.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,294.73 / $16,294.73 / $16,294.73
| Facility | | $16,294.73 | $16,294.73 | $16,294.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,214.47 / $24,472.94 / $31,375.56
| Facility | | $17,214.47 | $24,472.94 | $31,375.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,013.64 / $19,360.43 / $24,487.45
| Facility | | $10,013.64 | $19,360.43 | $24,487.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,897.34 / $13,374.40 / $21,386.30
| Facility | | $8,897.34 | $13,374.40 | $21,386.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,405.34 / $17,793.25 / $27,033.13
| Facility | | $10,405.34 | $17,793.25 | $27,033.13 |