- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,609.50 / $17,481.30 / $58,435.00
| Facility | | $13,609.50 | $17,481.30 | $58,435.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,306.04 / $17,307.75 / $28,990.07
| Facility | | $11,306.04 | $17,307.75 | $28,990.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,052.85 / $18,626.66 / $26,890.00
| Facility | | $15,052.85 | $18,626.66 | $26,890.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,999.67 / $17,893.04 / $50,556.16
| Facility | | $8,999.67 | $17,893.04 | $50,556.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $17,854.11 / $25,093.07
| Facility | | $9,226.00 | $17,854.11 | $25,093.07 |