- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,890.00 / $19,723.59 / $26,467.50
| Facility | | $11,890.00 | $19,723.59 | $26,467.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,220.18 / $12,220.18 / $12,220.18
| Facility | | $12,220.18 | $12,220.18 | $12,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,666.37 / $17,189.45 / $27,503.78
| Facility | | $9,666.37 | $17,189.45 | $27,503.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,763.33 / $15,880.50 / $36,420.33
| Facility | | $9,763.33 | $15,880.50 | $36,420.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,591.71 / $15,643.35 / $22,160.71
| Facility | | $11,591.71 | $15,643.35 | $22,160.71 |