- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,020.02 / $24,106.00 / $40,021.60
| Facility | | $18,020.02 | $24,106.00 | $40,021.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,476.20 / $11,476.20 / $19,578.15
| Facility | | $11,476.20 | $11,476.20 | $19,578.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,757.68 / $21,060.83 / $34,913.46
| Facility | | $13,757.68 | $21,060.83 | $34,913.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,778.59 / $25,711.81 / $36,970.44
| Facility | | $20,778.59 | $25,711.81 | $36,970.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,422.93 / $24,699.13 / $61,518.91
| Facility | | $12,422.93 | $24,699.13 | $61,518.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,422.93 / $24,645.40 / $34,637.89
| Facility | | $12,422.93 | $24,645.40 | $34,637.89 |