- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,815.59 / $22,573.30 / $37,477.10
| Facility | | $16,815.59 | $22,573.30 | $37,477.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,301.56 / $21,424.58 / $36,293.69
| Facility | | $14,301.56 | $21,424.58 | $36,293.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,509.21 / $23,898.00 / $34,066.00
| Facility | | $18,509.21 | $23,898.00 | $34,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,633.09 / $24,171.90 / $63,950.93
| Facility | | $11,633.09 | $24,171.90 | $63,950.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,095.63 / $21,344.42 / $32,021.47
| Facility | | $12,095.63 | $21,344.42 | $32,021.47 |