- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,942.90 / $17,736.90 / $24,777.00
| Facility | | $11,942.90 | $17,736.90 | $24,777.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,491.52 / $17,380.59 / $23,473.80
| Facility | | $11,491.52 | $17,380.59 | $23,473.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,575.81 / $15,810.00 / $22,239.38
| Facility | | $10,575.81 | $15,810.00 | $22,239.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,347.00 / $17,558.00 / $21,390.00
| Facility | | $11,347.00 | $17,558.00 | $21,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $15,904.13 / $27,204.43
| Facility | | $4,008.00 | $15,904.13 | $27,204.43 |