- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,678.30 / $18,514.00 / $24,333.80
| Facility | | $12,678.30 | $18,514.00 | $24,333.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,155.56 / $16,601.09 / $28,078.51
| Facility | | $6,155.56 | $16,601.09 | $28,078.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,879.37 / $18,596.30 / $33,323.42
| Facility | | $12,879.37 | $18,596.30 | $33,323.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,947.52 / $20,753.72 / $30,302.12
| Facility | | $15,947.52 | $20,753.72 | $30,302.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,947.52 / $19,293.34 / $30,302.12
| Facility | | $15,947.52 | $19,293.34 | $30,302.12 |