- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,576.30 / $15,543.40 / $23,997.70
| Facility | | $10,576.30 | $15,543.40 | $23,997.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,694.56 / $19,279.00 / $19,697.96
| Facility | | $16,694.56 | $19,279.00 | $19,697.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,534.73 / $27,771.54 / $35,604.54
| Facility | | $19,534.73 | $27,771.54 | $35,604.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,903.22 / $23,013.76 / $29,108.24
| Facility | | $11,903.22 | $23,013.76 | $29,108.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,576.30 / $15,898.20 / $25,421.90
| Facility | | $10,576.30 | $15,898.20 | $25,421.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,368.83 / $21,150.85 / $32,134.29
| Facility | | $12,368.83 | $21,150.85 | $32,134.29 |