- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,839.43 / $19,200.09 / $31,876.70
| Facility | | $14,839.43 | $19,200.09 | $31,876.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,964.00 / $12,522.32 / $23,481.50
| Facility | | $8,964.00 | $12,522.32 | $23,481.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,526.52 / $17,422.91 / $29,251.34
| Facility | | $11,526.52 | $17,422.91 | $29,251.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,549.89 / $20,479.13 / $29,507.00
| Facility | | $16,549.89 | $20,479.13 | $29,507.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,894.70 / $20,559.79 / $51,542.03
| Facility | | $9,894.70 | $20,559.79 | $51,542.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,894.70 / $19,629.74 / $27,588.64
| Facility | | $9,894.70 | $19,629.74 | $27,588.64 |