- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,977.10 / $17,490.09 / $22,988.00
| Facility | | $11,977.10 | $17,490.09 | $22,988.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,958.80 / $13,614.62 / $22,841.33
| Facility | | $4,958.80 | $13,614.62 | $22,841.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,606.40 / $17,648.75 / $31,480.38
| Facility | | $12,606.40 | $17,648.75 | $31,480.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,065.50 / $19,605.88 / $28,626.18
| Facility | | $15,065.50 | $19,605.88 | $28,626.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,463.91 / $18,866.41 / $27,194.76
| Facility | | $12,463.91 | $18,866.41 | $27,194.76 |