- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,549.60 / $18,326.09 / $24,086.80
| Facility | | $12,549.60 | $18,326.09 | $24,086.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,928.26 / $12,928.26 / $14,623.08
| Facility | | $12,928.26 | $12,928.26 | $14,623.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,103.29 / $19,344.95 / $32,719.37
| Facility | | $7,103.29 | $19,344.95 | $32,719.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,748.63 / $18,407.52 / $32,985.14
| Facility | | $12,748.63 | $18,407.52 | $32,985.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,785.63 / $20,543.04 / $29,994.51
| Facility | | $15,785.63 | $20,543.04 | $29,994.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,785.63 / $19,097.49 / $29,994.51
| Facility | | $15,785.63 | $19,097.49 | $29,994.51 |