- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,241.00 / $17,343.20 / $28,793.80
| Facility | | $11,241.00 | $17,343.20 | $28,793.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,007.81 / $14,143.89 / $24,390.97
| Facility | | $14,007.81 | $14,143.89 | $24,390.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,778.16 / $16,499.65 / $27,776.03
| Facility | | $10,778.16 | $16,499.65 | $27,776.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,547.15 / $17,664.37 / $26,598.62
| Facility | | $13,547.15 | $17,664.37 | $26,598.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,937.76 / $18,571.38 / $48,195.67
| Facility | | $8,937.76 | $18,571.38 | $48,195.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $17,546.91 / $24,920.44
| Facility | | $9,226.00 | $17,546.91 | $24,920.44 |