- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,151.10 / $25,189.60 / $39,347.90
| Facility | | $15,151.10 | $25,189.60 | $39,347.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,323.65 / $18,323.65 / $25,671.70
| Facility | | $18,323.65 | $18,323.65 | $25,671.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,444.09 / $21,542.24 / $32,636.96
| Facility | | $13,444.09 | $21,542.24 | $32,636.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,231.46 / $22,030.84 / $34,125.85
| Facility | | $14,231.46 | $22,030.84 | $34,125.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,960.62 / $23,774.33 / $35,340.90
| Facility | | $15,960.62 | $23,774.33 | $35,340.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $25,321.39 / $36,646.83
| Facility | | $10,403.00 | $25,321.39 | $36,646.83 |