- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,238.09 / $17,238.09 / $20,430.50
| Facility | | $17,238.09 | $17,238.09 | $20,430.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,448.73 / $20,254.75 / $30,299.87
| Facility | | $12,448.73 | $20,254.75 | $30,299.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,098.61 / $17,450.00 / $29,689.17
| Facility | | $14,098.61 | $17,450.00 | $29,689.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,613.78 / $20,238.84 / $33,128.07
| Facility | | $12,613.78 | $20,238.84 | $33,128.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.13 / $11,557.66 / $16,904.49
| Facility | | $183.13 | $11,557.66 | $16,904.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,353.87 / $19,995.12 / $23,499.28
| Facility | | $14,353.87 | $19,995.12 | $23,499.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,954.36 / $21,327.71 / $26,885.32
| Facility | | $12,954.36 | $21,327.71 | $26,885.32 |