- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,493.80 / $19,493.80 / $23,104.00
| Facility | | $19,493.80 | $19,493.80 | $23,104.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,101.80 / $22,944.39 / $34,323.41
| Facility | | $14,101.80 | $22,944.39 | $34,323.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,943.49 / $19,733.45 / $33,574.17
| Facility | | $15,943.49 | $19,733.45 | $33,574.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,264.37 / $22,887.21 / $37,463.07
| Facility | | $14,264.37 | $22,887.21 | $37,463.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.44 / $13,092.41 / $19,116.54
| Facility | | $207.44 | $13,092.41 | $19,116.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,232.15 / $22,611.59 / $26,574.29
| Facility | | $16,232.15 | $22,611.59 | $26,574.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,649.51 / $24,118.57 / $30,403.42
| Facility | | $14,649.51 | $24,118.57 | $30,403.42 |