- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,949.70 / $17,561.90 / $27,114.00
| Facility | | $11,949.70 | $17,561.90 | $27,114.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,207.31 / $42,944.21 / $55,056.68
| Facility | | $30,207.31 | $42,944.21 | $55,056.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,448.98 / $26,002.35 / $32,888.26
| Facility | | $13,448.98 | $26,002.35 | $32,888.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,949.70 / $17,962.80 / $28,723.20
| Facility | | $11,949.70 | $17,962.80 | $28,723.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,975.06 / $23,897.52 / $36,307.28
| Facility | | $13,975.06 | $23,897.52 | $36,307.28 |