- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,520.30 / $17,699.30 / $29,906.60
| Facility | | $10,520.30 | $17,699.30 | $29,906.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,687.00 / $13,477.00 / $18,211.08
| Facility | | $9,687.00 | $13,477.00 | $18,211.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,071.19 / $16,151.71 / $39,450.57
| Facility | | $11,071.19 | $16,151.71 | $39,450.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,542.59 / $10,138.95 / $23,260.01
| Facility | | $4,542.59 | $10,138.95 | $23,260.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,505.00 / $15,482.55 / $21,002.69
| Facility | | $6,505.00 | $15,482.55 | $21,002.69 |