- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,433.20 / $21,037.50 / $37,506.10
| Facility | | $13,433.20 | $21,037.50 | $37,506.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,401.63 / $19,643.70 / $23,991.44
| Facility | | $14,401.63 | $19,643.70 | $23,991.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,807.76 / $21,137.48 / $35,725.47
| Facility | | $13,807.76 | $21,137.48 | $35,725.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,472.59 / $24,694.20 / $43,128.66
| Facility | | $19,472.59 | $24,694.20 | $43,128.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,105.00 / $23,143.00 / $38,778.61
| Facility | | $12,105.00 | $23,143.00 | $38,778.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,642.10 / $23,096.34 / $32,460.77
| Facility | | $11,642.10 | $23,096.34 | $32,460.77 |