- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,476.20 / $21,356.80 / $35,457.30
| Facility | | $13,476.20 | $21,356.80 | $35,457.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,170.88 / $20,629.49 / $21,591.48
| Facility | | $14,170.88 | $20,629.49 | $21,591.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,129.64 / $19,668.98 / $33,319.67
| Facility | | $13,129.64 | $19,668.98 | $33,319.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,712.00 / $22,779.47 / $32,617.43
| Facility | | $17,712.00 | $22,779.47 | $32,617.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,006.14 / $22,869.19 / $58,710.58
| Facility | | $11,006.14 | $22,869.19 | $58,710.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,006.14 / $21,834.68 / $30,687.56
| Facility | | $11,006.14 | $21,834.68 | $30,687.56 |