- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,117.50 / $20,681.40 / $34,336.10
| Facility | | $16,117.50 | $20,681.40 | $34,336.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,952.00 / $16,932.00 / $23,389.13
| Facility | | $11,952.00 | $16,932.00 | $23,389.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,157.34 / $18,610.95 / $31,455.26
| Facility | | $12,157.34 | $18,610.95 | $31,455.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,826.75 / $22,059.14 / $31,718.35
| Facility | | $17,826.75 | $22,059.14 | $31,718.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,658.10 / $22,146.02 / $54,362.80
| Facility | | $10,658.10 | $22,146.02 | $54,362.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,658.10 / $21,144.22 / $29,717.16
| Facility | | $10,658.10 | $21,144.22 | $29,717.16 |