- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,470.67 / $23,403.80 / $38,886.00
| Facility | | $11,470.67 | $23,403.80 | $38,886.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,676.94 / $23,751.10 / $39,586.90
| Facility | | $13,676.94 | $23,751.10 | $39,586.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,112.95 / $20,073.84 / $34,390.00
| Facility | | $13,112.95 | $20,073.84 | $34,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,011.00 / $23,899.42 / $35,743.79
| Facility | | $18,011.00 | $23,899.42 | $35,743.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,540.63 / $25,061.19 / $40,174.14
| Facility | | $12,540.63 | $25,061.19 | $40,174.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,061.07 / $24,527.46 / $34,439.57
| Facility | | $12,061.07 | $24,527.46 | $34,439.57 |