- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,628.40 / $19,289.50 / $25,885.00
| Facility | | $11,628.40 | $19,289.50 | $25,885.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,519.80 / $12,253.38 / $16,448.15
| Facility | | $11,519.80 | $12,253.38 | $16,448.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,496.04 / $16,029.33 / $25,647.54
| Facility | | $9,496.04 | $16,029.33 | $25,647.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,548.45 / $15,531.00 / $35,618.80
| Facility | | $9,548.45 | $15,531.00 | $35,618.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,019.86 / $15,028.83 / $21,491.80
| Facility | | $9,019.86 | $15,028.83 | $21,491.80 |