- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,858.20 / $22,064.60 / $22,064.60
| Facility | | $19,858.20 | $22,064.60 | $22,064.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,636.41 / $19,316.06 / $20,384.00
| Facility | | $15,636.41 | $19,316.06 | $20,384.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,348.46 / $14,639.11 / $29,792.90
| Facility | | $9,348.46 | $14,639.11 | $29,792.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,805.00 / $24,293.89 / $38,179.54
| Facility | | $14,805.00 | $24,293.89 | $38,179.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $27,985.25 / $42,562.09
| Facility | | $6,965.00 | $27,985.25 | $42,562.09 |