- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,952.62 / $22,908.68
| Facility | | $14,454.40 | $19,952.62 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $17,378.01 / $17,378.01
| Facility | | $17,378.01 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $19,054.61 / $24,547.09
| Facility | | $10,964.78 | $19,054.61 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,454.40 / $35,481.34
| Facility | | $9,549.93 | $14,454.40 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,125.38 / $20,892.96
| Facility | | $9,332.54 | $14,125.38 | $20,892.96 |