- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,879.42 / $22,957.10 / $38,114.19
| Facility | | $14,879.42 | $22,957.10 | $38,114.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,956.00 / $19,632.41 / $28,605.52
| Facility | | $11,956.00 | $19,632.41 | $28,605.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,603.74 / $20,411.86 / $34,578.11
| Facility | | $11,603.74 | $20,411.86 | $34,578.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,773.00 / $24,486.38 / $35,208.42
| Facility | | $19,773.00 | $24,486.38 | $35,208.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,830.85 / $24,582.82 / $60,928.01
| Facility | | $11,830.85 | $24,582.82 | $60,928.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,830.85 / $23,470.79 / $32,987.03
| Facility | | $11,830.85 | $23,470.79 | $32,987.03 |