- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,442.58 / $14,194.00 / $21,425.30
| Facility | | $9,442.58 | $14,194.00 | $21,425.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,194.53 / $20,194.53 / $25,874.92
| Facility | | $20,194.53 | $20,194.53 | $25,874.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,562.14 / $26,388.85 / $33,831.86
| Facility | | $18,562.14 | $26,388.85 | $33,831.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,532.71 / $20,546.88 / $25,988.09
| Facility | | $11,532.71 | $20,546.88 | $25,988.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,442.58 / $14,329.80 / $21,751.10
| Facility | | $9,442.58 | $14,329.80 | $21,751.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,043.00 / $18,055.55 / $30,232.86
| Facility | | $11,043.00 | $18,055.55 | $30,232.86 |