- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,104.10 / $18,178.30 / $36,943.10
| Facility | | $14,104.10 | $18,178.30 | $36,943.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,749.73 / $20,530.71 / $23,943.40
| Facility | | $12,749.73 | $20,530.71 | $23,943.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,603.60 / $17,052.40 / $19,495.30
| Facility | | $13,603.60 | $17,052.40 | $19,495.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.10 / $19,928.03 / $25,917.26
| Facility | | $11,258.10 | $19,928.03 | $25,917.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,017.77 / $24,157.62 / $27,534.91
| Facility | | $20,017.77 | $24,157.62 | $27,534.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $15,981.78 / $24,612.34
| Facility | | $1,286.00 | $15,981.78 | $24,612.34 |