- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,932.80 / $20,368.90 / $33,108.00
| Facility | | $11,932.80 | $20,368.90 | $33,108.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,607.00 / $13,607.00 / $17,240.33
| Facility | | $13,607.00 | $13,607.00 | $17,240.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.33 / $16,184.09 / $25,531.96
| Facility | | $10,232.33 | $16,184.09 | $25,531.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,323.49 / $12,597.40 / $25,749.90
| Facility | | $6,323.49 | $12,597.40 | $25,749.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,928.92 / $18,541.34 / $24,611.35
| Facility | | $11,928.92 | $18,541.34 | $24,611.35 |