- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,103.00 / $15,639.30 / $17,698.30
| Facility | | $10,103.00 | $15,639.30 | $17,698.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,179.43 / $16,908.57 / $22,836.30
| Facility | | $11,179.43 | $16,908.57 | $22,836.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,329.40 / $13,720.14 / $19,907.24
| Facility | | $9,329.40 | $13,720.14 | $19,907.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,654.00 / $15,496.00 / $20,277.00
| Facility | | $10,654.00 | $15,496.00 | $20,277.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $14,609.70 / $23,998.28
| Facility | | $4,008.00 | $14,609.70 | $23,998.28 |