- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $30,902.95
| Facility | | $14,791.08 | $20,417.38 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $18,197.01 / $26,915.35
| Facility | | $11,481.54 | $18,197.01 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $17,782.79 / $31,622.78
| Facility | | $12,589.25 | $17,782.79 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.83 / $199.53 / $302.00
| Facility | | $131.83 | $199.53 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $19,952.62 / $28,840.32
| Facility | | $12,882.50 | $19,952.62 | $28,840.32 |