- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,997.50 / $20,375.30 / $28,621.80
| Facility | | $14,997.50 | $20,375.30 | $28,621.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,871.27 / $18,448.78 / $27,108.30
| Facility | | $11,871.27 | $18,448.78 | $27,108.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,083.34 / $18,062.33 / $32,692.00
| Facility | | $13,083.34 | $18,062.33 | $32,692.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.60 / $186.46 / $305.29
| Facility | | $130.60 | $186.46 | $305.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,410.63 / $19,943.75 / $32,822.76
| Facility | | $14,410.63 | $19,943.75 | $32,822.76 |