- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,994.96 / $22,012.30 / $36,545.60
| Facility | | $13,994.96 | $22,012.30 | $36,545.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,103.91 / $19,630.43 / $33,254.36
| Facility | | $13,103.91 | $19,630.43 | $33,254.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,278.00 / $23,478.66 / $33,618.58
| Facility | | $18,278.00 | $23,478.66 | $33,618.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,343.96 / $23,571.13 / $58,595.51
| Facility | | $11,343.96 | $23,571.13 | $58,595.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,795.00 / $20,813.93 / $31,225.61
| Facility | | $11,795.00 | $20,813.93 | $31,225.61 |