- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,496.40 / $14,817.30 / $30,112.70
| Facility | | $11,496.40 | $14,817.30 | $30,112.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,644.71 / $15,644.71 / $18,171.41
| Facility | | $15,644.71 | $15,644.71 | $18,171.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,742.30 / $13,465.70 / $15,394.78
| Facility | | $10,742.30 | $13,465.70 | $15,394.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,176.60 / $16,243.54 / $21,125.42
| Facility | | $9,176.60 | $16,243.54 | $21,125.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,991.41 / $17,991.41 / $20,897.13
| Facility | | $17,991.41 | $17,991.41 | $20,897.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $13,026.92 / $20,061.77
| Facility | | $1,286.00 | $13,026.92 | $20,061.77 |