- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,247.57 / $20,632.40 / $34,254.80
| Facility | | $15,247.57 | $20,632.40 | $34,254.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,950.37 / $28,950.37 / $28,950.37
| Facility | | $28,950.37 | $28,950.37 | $28,950.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,669.35 / $20,925.61 / $34,689.31
| Facility | | $13,669.35 | $20,925.61 | $34,689.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,661.00 / $21,014.53 / $33,346.00
| Facility | | $9,661.00 | $21,014.53 | $33,346.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,055.63 / $21,094.13 / $35,416.92
| Facility | | $11,055.63 | $21,094.13 | $35,416.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,632.86 / $20,523.00 / $29,646.76
| Facility | | $10,632.86 | $20,523.00 | $29,646.76 |