- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,278.50 / $19,614.30 / $26,757.40
| Facility | | $12,278.50 | $19,614.30 | $26,757.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,752.33 / $14,752.33 / $26,824.60
| Facility | | $14,752.33 | $14,752.33 | $26,824.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,729.21 / $17,192.04 / $26,046.31
| Facility | | $10,729.21 | $17,192.04 | $26,046.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,549.90 / $17,879.68 / $27,695.69
| Facility | | $11,549.90 | $17,879.68 | $27,695.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,511.88 / $17,879.68 / $26,969.09
| Facility | | $10,511.88 | $17,879.68 | $26,969.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,264.00 / $20,415.98 / $29,741.66
| Facility | | $7,264.00 | $20,415.98 | $29,741.66 |