- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,996.30 / $23,891.20 / $38,833.19
| Facility | | $13,996.30 | $23,891.20 | $38,833.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,886.70 / $20,475.11 / $21,650.76
| Facility | | $18,886.70 | $20,475.11 | $21,650.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,001.76 / $18,982.73 / $29,947.09
| Facility | | $12,001.76 | $18,982.73 | $29,947.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,989.15 / $24,171.80 / $53,322.44
| Facility | | $11,989.15 | $24,171.80 | $53,322.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,991.74 / $21,602.02 / $28,757.23
| Facility | | $13,991.74 | $21,602.02 | $28,757.23 |