- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,988.40 / $24,321.80 / $40,379.90
| Facility | | $15,988.40 | $24,321.80 | $40,379.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,952.00 / $19,046.98 / $36,381.74
| Facility | | $11,952.00 | $19,046.98 | $36,381.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,977.59 / $22,928.31 / $38,009.26
| Facility | | $14,977.59 | $22,928.31 | $38,009.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,200.52 / $25,941.97 / $37,212.00
| Facility | | $19,200.52 | $25,941.97 | $37,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,534.14 / $26,044.15 / $66,973.85
| Facility | | $12,534.14 | $26,044.15 | $66,973.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,534.14 / $24,866.01 / $34,947.94
| Facility | | $12,534.14 | $24,866.01 | $34,947.94 |