- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,044.00 / $16,362.80 / $25,485.00
| Facility | | $12,044.00 | $16,362.80 | $25,485.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,696.91 / $15,112.63 / $21,910.03
| Facility | | $9,696.91 | $15,112.63 | $21,910.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,506.85 / $14,505.34 / $26,254.00
| Facility | | $10,506.85 | $14,505.34 | $26,254.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.68 / $153.84 / $245.17
| Facility | | $111.68 | $153.84 | $245.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,572.76 / $16,016.25 / $26,359.02
| Facility | | $11,572.76 | $16,016.25 | $26,359.02 |