- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $22,387.21 / $38,018.94
| Facility | | $14,125.38 | $22,387.21 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $19,498.45 / $23,442.29
| Facility | | $12,589.25 | $19,498.45 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $22,908.68 / $67,608.30
| Facility | | $15,135.61 | $22,908.68 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $20,892.96 / $27,542.29
| Facility | | $12,302.69 | $20,892.96 | $27,542.29 |