- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,217.10 / $23,583.70 / $31,647.50
| Facility | | $14,217.10 | $23,583.70 | $31,647.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,687.94 / $15,687.94 / $16,164.42
| Facility | | $15,687.94 | $15,687.94 | $16,164.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,094.33 / $19,337.93 / $30,941.44
| Facility | | $11,094.33 | $19,337.93 | $30,941.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,674.13 / $18,988.50 / $43,548.23
| Facility | | $11,674.13 | $18,988.50 | $43,548.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,778.06 / $18,704.93 / $26,497.82
| Facility | | $13,778.06 | $18,704.93 | $26,497.82 |