- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,802.00 / $18,502.30 / $28,171.80
| Facility | | $12,802.00 | $18,502.30 | $28,171.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,682.49 / $18,177.23 / $26,677.22
| Facility | | $11,682.49 | $18,177.23 | $26,677.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,048.32 / $13,514.76 / $16,496.05
| Facility | | $11,048.32 | $13,514.76 | $16,496.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.55 / $198.84 / $855.54
| Facility | | $128.55 | $198.84 | $855.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,184.06 / $19,630.18 / $32,306.71
| Facility | | $14,184.06 | $19,630.18 | $32,306.71 |