- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,904.59 / $22,974.60 / $38,143.19
| Facility | | $17,904.59 | $22,974.60 | $38,143.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,670.77 / $14,670.77 / $14,940.00
| Facility | | $14,670.77 | $14,670.77 | $14,940.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,065.79 / $21,532.49 / $35,695.36
| Facility | | $14,065.79 | $21,532.49 | $35,695.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,945.93 / $23,400.04 / $35,235.25
| Facility | | $17,945.93 | $23,400.04 | $35,235.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,839.87 / $24,601.55 / $62,896.64
| Facility | | $11,839.87 | $24,601.55 | $62,896.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,839.87 / $23,488.67 / $33,012.17
| Facility | | $11,839.87 | $23,488.67 | $33,012.17 |