- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,462.30 / $17,292.20 / $28,679.60
| Facility | | $13,462.30 | $17,292.20 | $28,679.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,974.00 / $14,375.81 / $24,521.95
| Facility | | $9,974.00 | $14,375.81 | $24,521.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,445.70 / $15,990.72 / $26,508.53
| Facility | | $10,445.70 | $15,990.72 | $26,508.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,889.97 / $18,425.12 / $26,493.08
| Facility | | $14,889.97 | $18,425.12 | $26,493.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,256.25 / $19,436.64 / $29,652.58
| Facility | | $9,256.25 | $19,436.64 | $29,652.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $17,660.93 / $24,821.56
| Facility | | $9,226.00 | $17,660.93 | $24,821.56 |