- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,777.90 / $17,777.90 / $21,070.30
| Facility | | $17,777.90 | $17,777.90 | $21,070.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,365.91 / $20,120.00 / $30,098.30
| Facility | | $12,365.91 | $20,120.00 | $30,098.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,540.15 / $17,996.50 / $30,618.98
| Facility | | $14,540.15 | $17,996.50 | $30,618.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,008.82 / $20,872.68 / $34,165.58
| Facility | | $13,008.82 | $20,872.68 | $34,165.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.91 / $11,480.77 / $17,433.90
| Facility | | $181.91 | $11,480.77 | $17,433.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,803.40 / $20,621.33 / $24,235.23
| Facility | | $14,803.40 | $20,621.33 | $24,235.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,360.07 / $21,995.66 / $27,727.32
| Facility | | $13,360.07 | $21,995.66 | $27,727.32 |