- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,583.30 / $21,295.90 / $27,990.10
| Facility | | $14,583.30 | $21,295.90 | $27,990.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,034.98 / $18,813.81 / $26,067.11
| Facility | | $15,034.98 | $18,813.81 | $26,067.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,239.30 / $17,130.32 / $28,739.64
| Facility | | $6,239.30 | $17,130.32 | $28,739.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,814.60 / $21,390.55 / $35,802.94
| Facility | | $14,814.60 | $21,390.55 | $35,802.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,343.77 / $23,872.13 / $34,855.26
| Facility | | $18,343.77 | $23,872.13 | $34,855.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,343.77 / $22,192.33 / $34,855.26
| Facility | | $18,343.77 | $22,192.33 | $34,855.26 |