- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,120.50 / $16,239.30 / $21,344.00
| Facility | | $11,120.50 | $16,239.30 | $21,344.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,384.41 / $12,384.41 / $12,384.41
| Facility | | $12,384.41 | $12,384.41 | $12,384.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,856.56 / $15,949.62 / $26,976.63
| Facility | | $5,856.56 | $15,949.62 | $26,976.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,296.92 / $16,311.43 / $27,301.65
| Facility | | $11,296.92 | $16,311.43 | $27,301.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,988.10 / $18,203.77 / $26,578.99
| Facility | | $13,988.10 | $18,203.77 | $26,578.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,988.10 / $16,922.83 / $26,578.99
| Facility | | $13,988.10 | $16,922.83 | $26,578.99 |