- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,037.00 / $17,577.59 / $23,102.90
| Facility | | $12,037.00 | $17,577.59 | $23,102.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,099.50 / $11,164.48 / $18,883.21
| Facility | | $4,099.50 | $11,164.48 | $18,883.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,669.46 / $17,737.03 / $31,637.85
| Facility | | $12,669.46 | $17,737.03 | $31,637.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,140.86 / $19,703.95 / $28,769.38
| Facility | | $15,140.86 | $19,703.95 | $28,769.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,140.86 / $18,317.45 / $28,769.38
| Facility | | $15,140.86 | $18,317.45 | $28,769.38 |