- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $23,988.33 / $48,977.88
| Facility | | $20,417.38 | $23,988.33 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $20,892.96 / $31,622.78
| Facility | | $12,882.50 | $20,892.96 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $18,620.87 / $27,542.29
| Facility | | $15,488.17 | $18,620.87 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $14,791.08 / $19,498.45
| Facility | | $13,182.57 | $14,791.08 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $20,417.38 / $31,622.78
| Facility | | $15,488.17 | $20,417.38 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,378.01 / $23,442.29
| Facility | | $12,022.64 | $17,378.01 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $19,498.45 / $23,442.29
| Facility | | $15,135.61 | $19,498.45 | $23,442.29 |