- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,569.35 / $24,305.40 / $40,352.80
| Facility | | $15,569.35 | $24,305.40 | $40,352.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,979.86 / $20,342.15 / $35,168.81
| Facility | | $13,979.86 | $20,342.15 | $35,168.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,950.53 / $25,924.56 / $37,714.00
| Facility | | $20,950.53 | $25,924.56 | $37,714.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,525.72 / $24,903.49 / $59,419.66
| Facility | | $12,525.72 | $24,903.49 | $59,419.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,525.72 / $24,849.32 / $34,924.49
| Facility | | $12,525.72 | $24,849.32 | $34,924.49 |