- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,328.70 / $27,293.40 / $32,956.10
| Facility | | $14,328.70 | $27,293.40 | $32,956.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $24,645.45 / $41,948.93
| Facility | | $12,397.00 | $24,645.45 | $41,948.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,703.80 / $22,956.38 / $27,697.64
| Facility | | $18,703.80 | $22,956.38 | $27,697.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,466.73 / $18,774.80 / $25,218.48
| Facility | | $13,466.73 | $18,774.80 | $25,218.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,366.08 / $24,477.10 / $38,176.60
| Facility | | $14,366.08 | $24,477.10 | $38,176.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,907.92 / $22,039.86 / $29,809.56
| Facility | | $15,907.92 | $22,039.86 | $29,809.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $24,080.32 / $34,646.92
| Facility | | $3,775.00 | $24,080.32 | $34,646.92 |