- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,906.40 / $16,175.80 / $25,470.00
| Facility | | $11,906.40 | $16,175.80 | $25,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,506.11 / $14,939.98 / $21,579.25
| Facility | | $9,506.11 | $14,939.98 | $21,579.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,386.79 / $14,339.59 / $25,954.00
| Facility | | $10,386.79 | $14,339.59 | $25,954.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.84 / $148.55 / $236.75
| Facility | | $107.84 | $148.55 | $236.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,440.52 / $15,833.24 / $26,057.82
| Facility | | $11,440.52 | $15,833.24 | $26,057.82 |