- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,131.40 / $23,482.00 / $37,591.19
| Facility | | $15,131.40 | $23,482.00 | $37,591.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,376.66 / $26,376.66 / $26,376.66
| Facility | | $26,376.66 | $26,376.66 | $26,376.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,923.33 / $19,451.95 / $27,394.79
| Facility | | $9,923.33 | $19,451.95 | $27,394.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,982.42 / $18,732.33 / $32,821.53
| Facility | | $13,982.42 | $18,732.33 | $32,821.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,729.61 / $21,214.55 / $28,428.12
| Facility | | $13,729.61 | $21,214.55 | $28,428.12 |