- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,597.60 / $22,522.00 / $37,391.90
| Facility | | $14,597.60 | $22,522.00 | $37,391.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,011.54 / $20,990.11 / $35,557.69
| Facility | | $14,011.54 | $20,990.11 | $35,557.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,413.27 / $24,599.00 / $36,285.00
| Facility | | $19,413.27 | $24,599.00 | $36,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,606.64 / $24,116.94 / $62,654.06
| Facility | | $11,606.64 | $24,116.94 | $62,654.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,068.13 / $21,295.90 / $31,948.67
| Facility | | $12,068.13 | $21,295.90 | $31,948.67 |