- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,434.79 / $14,368.00 / $20,027.90
| Facility | | $10,434.79 | $14,368.00 | $20,027.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,747.78 / $24,432.43 / $40,294.26
| Facility | | $8,747.78 | $24,432.43 | $40,294.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,600.38 / $15,305.70 / $25,618.28
| Facility | | $10,600.38 | $15,305.70 | $25,618.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,125.62 / $17,081.36 / $24,940.18
| Facility | | $13,125.62 | $17,081.36 | $24,940.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,125.62 / $15,879.40 / $24,940.18
| Facility | | $13,125.62 | $15,879.40 | $24,940.18 |