- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,015.50 / $14,625.50 / $19,223.00
| Facility | | $10,015.50 | $14,625.50 | $19,223.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,900.70 / $26,963.36 / $45,604.89
| Facility | | $9,900.70 | $26,963.36 | $45,604.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,174.33 / $14,690.54 / $24,588.65
| Facility | | $10,174.33 | $14,690.54 | $24,588.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,598.08 / $16,394.84 / $23,937.80
| Facility | | $12,598.08 | $16,394.84 | $23,937.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,481.16 / $15,776.49 / $22,740.82
| Facility | | $10,481.16 | $15,776.49 | $22,740.82 |