- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,592.10 / $16,229.50 / $32,982.60
| Facility | | $12,592.10 | $16,229.50 | $32,982.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,803.74 / $17,803.74 / $18,041.00
| Facility | | $17,803.74 | $17,803.74 | $18,041.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,289.07 / $16,658.13 / $19,044.55
| Facility | | $13,289.07 | $16,658.13 | $19,044.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,051.18 / $17,791.65 / $23,138.81
| Facility | | $10,051.18 | $17,791.65 | $23,138.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,474.30 / $20,474.30 / $20,747.16
| Facility | | $20,474.30 | $20,474.30 | $20,747.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $14,268.46 / $21,973.79
| Facility | | $1,286.00 | $14,268.46 | $21,973.79 |