- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,011.30 / $21,689.20 / $24,544.80
| Facility | | $14,011.30 | $21,689.20 | $24,544.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,180.55 / $16,910.25 / $23,257.87
| Facility | | $11,180.55 | $16,910.25 | $23,257.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,929.62 / $19,027.63 / $30,483.77
| Facility | | $12,929.62 | $19,027.63 | $30,483.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,264.00 / $19,143.77 / $27,738.00
| Facility | | $13,264.00 | $19,143.77 | $27,738.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $25,066.79 / $33,361.87
| Facility | | $5,274.00 | $25,066.79 | $33,361.87 |