- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,315.10 / $20,611.59 / $23,325.30
| Facility | | $13,315.10 | $20,611.59 | $23,325.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,026.53 / $18,189.78 / $24,566.67
| Facility | | $12,026.53 | $18,189.78 | $24,566.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,295.55 / $16,936.57 / $25,634.00
| Facility | | $12,295.55 | $16,936.57 | $25,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,530.00 / $18,304.00 / $23,687.00
| Facility | | $12,530.00 | $18,304.00 | $23,687.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $23,821.36 / $31,704.32
| Facility | | $5,274.00 | $23,821.36 | $31,704.32 |