- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,594.08 / $14,099.90 / $21,769.10
| Facility | | $9,594.08 | $14,099.90 | $21,769.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,988.77 / $24,152.08 / $30,964.20
| Facility | | $16,988.77 | $24,152.08 | $30,964.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67.67 / $20,112.31 / $26,405.03
| Facility | | $67.67 | $20,112.31 | $26,405.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,594.08 / $14,421.80 / $23,061.00
| Facility | | $9,594.08 | $14,421.80 | $23,061.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.16 / $19,186.62 / $29,150.05
| Facility | | $11,220.16 | $19,186.62 | $29,150.05 |