- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,277.10 / $20,552.59 / $23,258.60
| Facility | | $13,277.10 | $20,552.59 | $23,258.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,628.21 / $20,612.27 / $27,838.43
| Facility | | $13,628.21 | $20,612.27 | $27,838.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,260.41 / $16,888.16 / $25,781.86
| Facility | | $12,260.41 | $16,888.16 | $25,781.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,327.00 / $19,048.00 / $24,632.00
| Facility | | $12,327.00 | $19,048.00 | $24,632.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $23,753.28 / $31,613.71
| Facility | | $5,274.00 | $23,753.28 | $31,613.71 |