- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,743.59 / $19,715.09 / $19,715.09
| Facility | | $17,743.59 | $19,715.09 | $19,715.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,926.51 / $15,926.51 / $15,926.51
| Facility | | $15,926.51 | $15,926.51 | $15,926.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,404.45 / $13,849.87 / $31,207.93
| Facility | | $8,404.45 | $13,849.87 | $31,207.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,921.00 / $22,244.00 / $34,113.98
| Facility | | $15,921.00 | $22,244.00 | $34,113.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $29,453.84 / $38,029.83
| Facility | | $6,965.00 | $29,453.84 | $38,029.83 |