- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,468.00 / $22,341.10 / $29,980.00
| Facility | | $13,468.00 | $22,341.10 | $29,980.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,601.44 / $11,705.03 / $12,544.36
| Facility | | $6,601.44 | $11,705.03 | $12,544.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,301.28 / $18,041.97 / $28,867.85
| Facility | | $10,301.28 | $18,041.97 | $28,867.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,059.02 / $17,988.00 / $41,253.68
| Facility | | $11,059.02 | $17,988.00 | $41,253.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,052.09 / $17,653.41 / $25,101.65
| Facility | | $13,052.09 | $17,653.41 | $25,101.65 |