- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,276.70 / $17,500.09 / $28,015.00
| Facility | | $11,276.70 | $17,500.09 | $28,015.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,615.24 / $14,615.24 / $14,615.24
| Facility | | $14,615.24 | $14,615.24 | $14,615.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,840.98 / $13,307.96 / $18,885.50
| Facility | | $6,840.98 | $13,307.96 | $18,885.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,724.85 / $15,977.73 / $24,460.40
| Facility | | $10,724.85 | $15,977.73 | $24,460.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.04 / $15,440.51 / $21,186.19
| Facility | | $10,232.04 | $15,440.51 | $21,186.19 |