- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,706.00 / $16,376.40 / $33,281.10
| Facility | | $12,706.00 | $16,376.40 | $33,281.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,621.26 / $17,474.83 / $20,770.66
| Facility | | $11,621.26 | $17,474.83 | $20,770.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,408.67 / $15,554.53 / $17,782.84
| Facility | | $12,408.67 | $15,554.53 | $17,782.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,142.12 / $17,952.64 / $23,348.18
| Facility | | $10,142.12 | $17,952.64 | $23,348.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,676.85 / $21,154.93 / $23,886.26
| Facility | | $15,676.85 | $21,154.93 | $23,886.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $14,397.57 / $22,172.62
| Facility | | $1,286.00 | $14,397.57 | $22,172.62 |