- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,016.00 / $16,701.70 / $27,728.70
| Facility | | $13,016.00 | $16,701.70 | $27,728.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,892.57 / $15,068.69 / $25,468.32
| Facility | | $9,892.57 | $15,068.69 | $25,468.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,396.32 / $18,256.73 / $26,977.00
| Facility | | $14,396.32 | $18,256.73 | $26,977.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $17,884.43 / $44,015.83
| Facility | | $8,787.00 | $17,884.43 | $44,015.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,949.37 / $17,075.41 / $23,998.64
| Facility | | $8,949.37 | $17,075.41 | $23,998.64 |