- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,344.80 / $17,344.80 / $20,557.00
| Facility | | $17,344.80 | $17,344.80 | $20,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,615.45 / $20,526.02 / $30,705.67
| Facility | | $12,615.45 | $20,526.02 | $30,705.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,185.93 / $17,558.09 / $29,873.06
| Facility | | $14,185.93 | $17,558.09 | $29,873.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,691.91 / $20,364.20 / $33,333.26
| Facility | | $12,691.91 | $20,364.20 | $33,333.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.58 / $11,712.45 / $17,009.18
| Facility | | $185.58 | $11,712.45 | $17,009.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,442.77 / $20,118.96 / $23,644.83
| Facility | | $14,442.77 | $20,118.96 | $23,644.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,034.60 / $21,459.81 / $27,051.84
| Facility | | $13,034.60 | $21,459.81 | $27,051.84 |