- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,692.07 / $20,598.59 / $34,198.60
| Facility | | $15,692.07 | $20,598.59 | $34,198.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,504.00 / $18,946.15 / $20,035.88
| Facility | | $9,504.00 | $18,946.15 | $20,035.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,155.94 / $18,210.32 / $30,848.67
| Facility | | $12,155.94 | $18,210.32 | $30,848.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,755.36 / $21,970.81 / $31,591.34
| Facility | | $17,755.36 | $21,970.81 | $31,591.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,615.43 / $22,057.34 / $54,356.58
| Facility | | $10,615.43 | $22,057.34 | $54,356.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,615.43 / $20,840.57 / $29,220.24
| Facility | | $10,615.43 | $20,840.57 | $29,220.24 |