- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,421.29 / $22,265.40 / $36,965.80
| Facility | | $14,421.29 | $22,265.40 | $36,965.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,418.02 / $17,104.87 / $30,113.70
| Facility | | $11,418.02 | $17,104.87 | $30,113.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,256.72 / $23,748.62 / $33,859.00
| Facility | | $18,256.72 | $23,748.62 | $33,859.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,474.40 / $22,813.26 / $51,056.87
| Facility | | $11,474.40 | $22,813.26 | $51,056.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,474.40 / $22,763.63 / $31,993.16
| Facility | | $11,474.40 | $22,763.63 | $31,993.16 |