- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,612.00 / $16,957.00 / $22,287.30
| Facility | | $11,612.00 | $16,957.00 | $22,287.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,049.82 / $19,355.63 / $32,473.07
| Facility | | $7,049.82 | $19,355.63 | $32,473.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,796.23 / $17,032.37 / $28,508.34
| Facility | | $11,796.23 | $17,032.37 | $28,508.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,606.35 / $19,008.34 / $27,753.74
| Facility | | $14,606.35 | $19,008.34 | $27,753.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,084.04 / $18,291.43 / $26,819.13
| Facility | | $12,084.04 | $18,291.43 | $26,819.13 |