- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,473.50 / $18,906.90 / $25,713.40
| Facility | | $13,473.50 | $18,906.90 | $25,713.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,751.13 / $16,702.90 / $24,405.50
| Facility | | $10,751.13 | $16,702.90 | $24,405.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,753.87 / $16,226.93 / $29,370.00
| Facility | | $11,753.87 | $16,226.93 | $29,370.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.05 / $172.09 / $274.27
| Facility | | $123.05 | $172.09 | $274.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,946.30 / $17,917.16 / $29,487.48
| Facility | | $12,946.30 | $17,917.16 | $29,487.48 |