- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,357.60 / $19,726.59 / $32,717.20
| Facility | | $15,357.60 | $19,726.59 | $32,717.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,659.92 / $13,223.00 / $29,944.00
| Facility | | $10,659.92 | $13,223.00 | $29,944.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,644.75 / $17,444.53 / $29,551.39
| Facility | | $11,644.75 | $17,444.53 | $29,551.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,986.23 / $21,019.07 / $30,222.86
| Facility | | $16,986.23 | $21,019.07 | $30,222.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,155.58 / $20,191.21 / $52,070.73
| Facility | | $10,155.58 | $20,191.21 | $52,070.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,155.58 / $20,147.29 / $28,316.02
| Facility | | $10,155.58 | $20,147.29 | $28,316.02 |