- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,267.46 / $21,293.50 / $56,574.80
| Facility | | $16,267.46 | $21,293.50 | $56,574.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,504.97 / $18,484.25 / $32,674.48
| Facility | | $12,504.97 | $18,484.25 | $32,674.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,792.63 / $21,722.09 / $35,370.00
| Facility | | $16,792.63 | $21,722.09 | $35,370.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,398.13 / $22,778.01 / $46,181.00
| Facility | | $11,398.13 | $22,778.01 | $46,181.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,962.26 / $22,292.91 / $46,181.00
| Facility | | $10,962.26 | $22,292.91 | $46,181.00 |