- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,975.10 / $21,161.20 / $37,024.19
| Facility | | $15,975.10 | $21,161.20 | $37,024.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,692.89 / $17,035.90 / $26,890.16
| Facility | | $11,692.89 | $17,035.90 | $26,890.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $17,625.23 / $36,101.08
| Facility | | $5,939.30 | $17,625.23 | $36,101.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,134.00 / $20,302.46 / $33,056.10
| Facility | | $13,134.00 | $20,302.46 | $33,056.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,311.76 / $16,025.33 / $23,911.26
| Facility | | $14,311.76 | $16,025.33 | $23,911.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $21,807.68 / $33,308.53
| Facility | | $3,496.00 | $21,807.68 | $33,308.53 |