- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,402.60 / $17,274.09 / $35,105.50
| Facility | | $13,402.60 | $17,274.09 | $35,105.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,801.38 / $19,612.24 / $21,012.57
| Facility | | $14,801.38 | $19,612.24 | $21,012.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,089.95 / $17,662.05 / $20,192.29
| Facility | | $14,089.95 | $17,662.05 | $20,192.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,698.12 / $18,936.79 / $24,628.11
| Facility | | $10,698.12 | $18,936.79 | $24,628.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,021.59 / $22,427.45 / $25,215.08
| Facility | | $17,021.59 | $22,427.45 | $25,215.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $17,206.75 / $24,190.46
| Facility | | $1,518.00 | $17,206.75 | $24,190.46 |