- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,485.20 / $16,749.30 / $27,189.30
| Facility | | $11,485.20 | $16,749.30 | $27,189.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,346.16 / $37,454.99 / $48,019.22
| Facility | | $26,346.16 | $37,454.99 | $48,019.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,486.32 / $26,074.54 / $32,979.58
| Facility | | $13,486.32 | $26,074.54 | $32,979.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,982.90 / $18,012.59 / $28,803.00
| Facility | | $11,982.90 | $18,012.59 | $28,803.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,771.09 / $23,963.87 / $36,408.08
| Facility | | $15,771.09 | $23,963.87 | $36,408.08 |