- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,788.62 / $20,410.80 / $37,078.00
| Facility | | $13,788.62 | $20,410.80 | $37,078.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,032.07 / $16,032.07 / $19,147.78
| Facility | | $16,032.07 | $16,032.07 | $19,147.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,412.58 / $19,001.70 / $32,068.28
| Facility | | $12,412.58 | $19,001.70 | $32,068.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,926.94 / $20,767.43 / $31,271.13
| Facility | | $15,926.94 | $20,767.43 | $31,271.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,507.83 / $20,891.54 / $55,504.17
| Facility | | $10,507.83 | $20,891.54 | $55,504.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,507.83 / $20,846.09 / $29,298.16
| Facility | | $10,507.83 | $20,846.09 | $29,298.16 |