- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,642.30 / $18,534.20 / $29,183.40
| Facility | | $13,642.30 | $18,534.20 | $29,183.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,104.91 / $16,919.08 / $24,721.37
| Facility | | $11,104.91 | $16,919.08 | $24,721.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,835.72 / $15,863.74 / $29,738.00
| Facility | | $11,835.72 | $15,863.74 | $29,738.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.59 / $174.25 / $277.70
| Facility | | $124.59 | $174.25 | $277.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,108.51 / $18,141.66 / $29,856.95
| Facility | | $13,108.51 | $18,141.66 | $29,856.95 |