- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $19,054.61 / $19,952.62
| Facility | | $16,218.10 | $19,054.61 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $20,417.38 / $29,512.09
| Facility | | $11,748.98 | $20,417.38 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $16,982.44 / $30,199.52
| Facility | | $12,302.69 | $16,982.44 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $16,218.10 / $20,417.38
| Facility | | $14,125.38 | $16,218.10 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $19,054.61 / $30,902.95
| Facility | | $11,748.98 | $19,054.61 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $12,302.69 / $15,848.93
| Facility | | $134.90 | $12,302.69 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $21,877.62 / $22,908.68
| Facility | | $17,782.79 | $21,877.62 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $20,417.38 / $27,542.29
| Facility | | $11,748.98 | $20,417.38 | $27,542.29 |