- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,424.09 / $13,762.00 / $18,088.00
| Facility | | $9,424.09 | $13,762.00 | $18,088.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,364.06 / $14,608.35 / $24,708.05
| Facility | | $5,364.06 | $14,608.35 | $24,708.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,573.59 / $13,823.14 / $24,770.20
| Facility | | $9,573.59 | $13,823.14 | $24,770.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,854.23 / $15,426.80 / $22,524.39
| Facility | | $11,854.23 | $15,426.80 | $22,524.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,854.23 / $14,341.27 / $22,524.39
| Facility | | $11,854.23 | $14,341.27 | $22,524.39 |