- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,065.00 / $16,696.20 / $22,405.00
| Facility | | $10,065.00 | $16,696.20 | $22,405.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,558.03 / $13,822.83 / $21,773.57
| Facility | | $11,558.03 | $13,822.83 | $21,773.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,176.83 / $14,322.99 / $22,914.40
| Facility | | $8,176.83 | $14,322.99 | $22,914.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,264.76 / $13,443.00 / $30,830.18
| Facility | | $8,264.76 | $13,443.00 | $30,830.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,812.49 / $13,242.25 / $18,759.25
| Facility | | $9,812.49 | $13,242.25 | $18,759.25 |