- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,968.10 / $21,004.30 / $32,995.10
| Facility | | $14,968.10 | $21,004.30 | $32,995.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,180.30 / $18,485.75 / $27,115.37
| Facility | | $12,180.30 | $18,485.75 | $27,115.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,057.73 / $18,026.97 / $32,628.00
| Facility | | $13,057.73 | $18,026.97 | $32,628.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.35 / $186.09 / $304.70
| Facility | | $130.35 | $186.09 | $304.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,382.42 / $19,904.71 / $32,758.51
| Facility | | $14,382.42 | $19,904.71 | $32,758.51 |