- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,084.50 / $18,361.00 / $24,971.00
| Facility | | $13,084.50 | $18,361.00 | $24,971.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,353.78 / $16,245.83 / $23,643.08
| Facility | | $10,353.78 | $16,245.83 | $23,643.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,414.50 / $15,758.41 / $28,522.00
| Facility | | $11,414.50 | $15,758.41 | $28,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.00 / $167.12 / $266.35
| Facility | | $120.00 | $167.12 | $266.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,929.33 / $17,377.03 / $27,583.63
| Facility | | $11,929.33 | $17,377.03 | $27,583.63 |