- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,209.49 / $18,654.20 / $30,970.40
| Facility | | $14,209.49 | $18,654.20 | $30,970.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $15,471.53 / $20,916.00
| Facility | | $7,212.00 | $15,471.53 | $20,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,517.48 / $17,631.43 / $29,228.40
| Facility | | $11,517.48 | $17,631.43 | $29,228.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,079.36 / $19,926.00 / $29,392.00
| Facility | | $16,079.36 | $19,926.00 | $29,392.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,613.39 / $19,975.25 / $51,501.60
| Facility | | $9,613.39 | $19,975.25 | $51,501.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,613.39 / $19,071.65 / $26,804.27
| Facility | | $9,613.39 | $19,071.65 | $26,804.27 |