- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,493.70 / $25,702.90 / $31,035.60
| Facility | | $13,493.70 | $25,702.90 | $31,035.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $23,209.25 / $39,838.94
| Facility | | $12,397.00 | $23,209.25 | $39,838.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,141.37 / $21,618.60 / $24,936.44
| Facility | | $16,141.37 | $21,618.60 | $24,936.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,689.69 / $18,981.59 / $25,308.80
| Facility | | $11,689.69 | $18,981.59 | $25,308.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,768.33 / $22,833.58 / $32,284.80
| Facility | | $13,768.33 | $22,833.58 | $32,284.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,239.52 / $19,568.30 / $25,799.78
| Facility | | $15,239.52 | $19,568.30 | $25,799.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,958.00 / $23,990.81 / $29,254.45
| Facility | | $13,958.00 | $23,990.81 | $29,254.45 |