- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,392.10 / $22,477.00 / $29,542.60
| Facility | | $15,392.10 | $22,477.00 | $29,542.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,103.26 / $13,898.11 / $23,506.78
| Facility | | $5,103.26 | $13,898.11 | $23,506.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,200.89 / $22,680.97 / $40,456.44
| Facility | | $16,200.89 | $22,680.97 | $40,456.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,361.16 / $25,196.14 / $36,788.42
| Facility | | $19,361.16 | $25,196.14 | $36,788.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,361.16 / $23,423.17 / $36,788.42
| Facility | | $19,361.16 | $23,423.17 | $36,788.42 |