- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,605.60 / $18,484.30 / $29,104.90
| Facility | | $13,605.60 | $18,484.30 | $29,104.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,075.04 / $16,873.57 / $24,654.87
| Facility | | $11,075.04 | $16,873.57 | $24,654.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,869.13 / $16,386.05 / $29,658.00
| Facility | | $11,869.13 | $16,386.05 | $29,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.25 / $173.78 / $276.95
| Facility | | $124.25 | $173.78 | $276.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,303.36 / $17,434.46 / $28,143.96
| Facility | | $12,303.36 | $17,434.46 | $28,143.96 |