- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,308.40 / $30,370.60 / $40,755.00
| Facility | | $18,308.40 | $30,370.60 | $40,755.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,914.65 / $20,426.86 / $26,140.97
| Facility | | $13,914.65 | $20,426.86 | $26,140.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,831.88 / $25,977.01 / $41,564.21
| Facility | | $14,831.88 | $25,977.01 | $41,564.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,033.70 / $24,453.00 / $56,080.51
| Facility | | $15,033.70 | $24,453.00 | $56,080.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,849.06 / $24,087.84 / $34,123.35
| Facility | | $17,849.06 | $24,087.84 | $34,123.35 |