- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,856.00 / $17,466.00 / $24,535.00
| Facility | | $12,856.00 | $17,466.00 | $24,535.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,462.66 / $15,967.19 / $23,378.48
| Facility | | $10,462.66 | $15,967.19 | $23,378.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,215.20 / $15,731.27 / $28,024.00
| Facility | | $11,215.20 | $15,731.27 | $28,024.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.21 / $164.21 / $261.70
| Facility | | $119.21 | $164.21 | $261.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,665.19 / $16,473.91 / $26,593.37
| Facility | | $11,665.19 | $16,473.91 | $26,593.37 |