- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,305.10 / $19,429.40 / $25,537.00
| Facility | | $13,305.10 | $19,429.40 | $25,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,110.81 / $22,088.80 / $37,360.23
| Facility | | $8,110.81 | $22,088.80 | $37,360.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,004.26 / $19,605.72 / $34,971.07
| Facility | | $14,004.26 | $19,605.72 | $34,971.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,736.04 / $21,779.87 / $31,800.39
| Facility | | $16,736.04 | $21,779.87 | $31,800.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,736.04 / $20,247.29 / $31,800.39
| Facility | | $16,736.04 | $20,247.29 | $31,800.39 |