- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,432.20 / $18,518.90 / $30,745.80
| Facility | | $14,432.20 | $18,518.90 | $30,745.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,787.90 / $16,514.56 / $27,543.71
| Facility | | $10,787.90 | $16,514.56 | $27,543.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,962.74 / $19,752.58 / $28,401.79
| Facility | | $15,962.74 | $19,752.58 | $28,401.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,543.66 / $18,974.59 / $48,239.21
| Facility | | $9,543.66 | $18,974.59 | $48,239.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,543.66 / $18,933.32 / $26,609.85
| Facility | | $9,543.66 | $18,933.32 | $26,609.85 |