- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,345.00 / $17,323.30 / $27,212.70
| Facility | | $12,345.00 | $17,323.30 | $27,212.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,932.62 / $15,328.96 / $22,444.01
| Facility | | $9,932.62 | $15,328.96 | $22,444.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,769.38 / $14,867.78 / $26,910.00
| Facility | | $10,769.38 | $14,867.78 | $26,910.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.47 / $157.68 / $251.30
| Facility | | $114.47 | $157.68 | $251.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,861.93 / $16,416.45 / $27,017.64
| Facility | | $11,861.93 | $16,416.45 | $27,017.64 |