- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,407.10 / $17,759.50 / $31,072.50
| Facility | | $13,407.10 | $17,759.50 | $31,072.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,361.10 / $14,815.00 / $21,848.04
| Facility | | $10,361.10 | $14,815.00 | $21,848.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $15,504.11 / $31,520.48
| Facility | | $5,939.30 | $15,504.11 | $31,520.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,300.76 / $17,470.00 / $27,742.28
| Facility | | $12,300.76 | $17,470.00 | $27,742.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $18,302.06 / $27,954.13
| Facility | | $3,496.00 | $18,302.06 | $27,954.13 |