- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,920.23 / $21,752.20 / $36,113.80
| Facility | | $15,920.23 | $21,752.20 | $36,113.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,910.56 / $19,764.02 / $33,404.11
| Facility | | $12,910.56 | $19,764.02 | $33,404.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,991.09 / $22,155.01 / $33,360.51
| Facility | | $16,991.09 | $22,155.01 | $33,360.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,209.91 / $23,292.60 / $57,730.93
| Facility | | $11,209.91 | $23,292.60 | $57,730.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,209.91 / $22,007.68 / $31,255.72
| Facility | | $11,209.91 | $22,007.68 | $31,255.72 |