- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,260.00 / $16,240.10 / $28,414.00
| Facility | | $12,260.00 | $16,240.10 | $28,414.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,477.00 / $19,889.05 / $26,203.16
| Facility | | $11,477.00 | $19,889.05 | $26,203.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,232.52 / $28,092.51
| Facility | | $5,939.30 | $14,232.52 | $28,092.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,248.35 / $16,494.30 / $25,368.75
| Facility | | $11,248.35 | $16,494.30 | $25,368.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $16,736.20 / $25,562.48
| Facility | | $3,496.00 | $16,736.20 | $25,562.48 |