- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,105.86 / $19,804.30 / $32,879.80
| Facility | | $14,105.86 | $19,804.30 | $32,879.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,508.00 / $13,508.00 / $19,104.07
| Facility | | $13,508.00 | $13,508.00 | $19,104.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,779.68 / $17,979.68 / $29,893.80
| Facility | | $11,779.68 | $17,979.68 | $29,893.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,187.84 / $21,648.23 / $30,373.12
| Facility | | $17,187.84 | $21,648.23 | $30,373.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,206.08 / $20,291.59 / $52,674.07
| Facility | | $10,206.08 | $20,291.59 | $52,674.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,206.08 / $20,247.46 / $28,456.80
| Facility | | $10,206.08 | $20,247.46 | $28,456.80 |