- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,818.50 / $19,014.70 / $31,568.80
| Facility | | $14,818.50 | $19,014.70 | $31,568.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,672.00 / $18,034.50 / $21,134.09
| Facility | | $12,672.00 | $18,034.50 | $21,134.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,571.03 / $17,713.41 / $29,364.30
| Facility | | $11,571.03 | $17,713.41 | $29,364.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,390.03 / $20,281.32 / $29,162.06
| Facility | | $16,390.03 | $20,281.32 | $29,162.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,799.12 / $20,361.20 / $51,741.07
| Facility | | $9,799.12 | $20,361.20 | $51,741.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,799.12 / $19,440.14 / $27,322.15
| Facility | | $9,799.12 | $19,440.14 | $27,322.15 |