- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,993.74 / $13,217.60 / $20,406.90
| Facility | | $8,993.74 | $13,217.60 | $20,406.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,729.88 / $17,000.00 / $20,131.89
| Facility | | $10,729.88 | $17,000.00 | $20,131.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,434.49 / $19,099.14 / $24,486.08
| Facility | | $13,434.49 | $19,099.14 | $24,486.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,122.14 / $19,570.21 / $24,752.78
| Facility | | $10,122.14 | $19,570.21 | $24,752.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,993.74 / $13,519.30 / $21,618.00
| Facility | | $8,993.74 | $13,519.30 | $21,618.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,518.08 / $17,175.75 / $27,011.40
| Facility | | $10,518.08 | $17,175.75 | $27,011.40 |