- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,511.00 / $15,856.56 / $15,856.56
| Facility | | $14,511.00 | $15,856.56 | $15,856.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,894.01 / $18,550.68 / $30,091.46
| Facility | | $9,894.01 | $18,550.68 | $30,091.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,092.29 / $30,166.00 / $35,668.00
| Facility | | $16,092.29 | $30,166.00 | $35,668.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,564.29 / $21,597.31 / $31,728.94
| Facility | | $13,564.29 | $21,597.31 | $31,728.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,589.18 / $18,188.45 / $30,610.01
| Facility | | $17,589.18 | $18,188.45 | $30,610.01 |