- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,761.80 / $24,487.30 / $32,860.00
| Facility | | $14,761.80 | $24,487.30 | $32,860.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,578.28 / $19,912.28 / $28,599.72
| Facility | | $15,578.28 | $19,912.28 | $28,599.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,747.29 / $20,461.24 / $31,637.97
| Facility | | $11,747.29 | $20,461.24 | $31,637.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,121.40 / $19,716.00 / $45,216.67
| Facility | | $12,121.40 | $19,716.00 | $45,216.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,391.37 / $19,421.57 / $27,513.02
| Facility | | $14,391.37 | $19,421.57 | $27,513.02 |