- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,550.60 / $24,137.00 / $32,390.00
| Facility | | $14,550.60 | $24,137.00 | $32,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,902.71 / $16,902.71 / $20,831.34
| Facility | | $16,902.71 | $16,902.71 | $20,831.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,896.17 / $20,835.32 / $33,337.31
| Facility | | $11,896.17 | $20,835.32 | $33,337.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,948.02 / $19,434.00 / $44,569.94
| Facility | | $11,948.02 | $19,434.00 | $44,569.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,185.52 / $19,143.79 / $27,453.76
| Facility | | $14,185.52 | $19,143.79 | $27,453.76 |