- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,138.00 / $26,909.80 / $44,775.20
| Facility | | $16,138.00 | $26,909.80 | $44,775.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,747.75 / $23,443.49 / $27,639.87
| Facility | | $11,747.75 | $23,443.49 | $27,639.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,921.47 / $21,887.35 / $34,529.41
| Facility | | $13,921.47 | $21,887.35 | $34,529.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,712.64 / $29,344.38 / $57,362.40
| Facility | | $13,712.64 | $29,344.38 | $57,362.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,762.33 / $25,434.79 / $46,000.00
| Facility | | $17,762.33 | $25,434.79 | $46,000.00 |