- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,383.10 / $18,455.90 / $30,641.20
| Facility | | $14,383.10 | $18,455.90 | $30,641.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,964.00 / $8,964.00 / $18,715.00
| Facility | | $8,964.00 | $8,964.00 | $18,715.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,339.48 / $17,299.24 / $29,238.27
| Facility | | $11,339.48 | $17,299.24 | $29,238.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,908.44 / $19,685.39 / $28,703.00
| Facility | | $15,908.44 | $19,685.39 | $28,703.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,511.20 / $19,843.62 / $31,680.81
| Facility | | $9,511.20 | $19,843.62 | $31,680.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,511.20 / $18,868.93 / $26,519.35
| Facility | | $9,511.20 | $18,868.93 | $26,519.35 |