- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,890.70 / $17,890.70 / $21,204.00
| Facility | | $17,890.70 | $17,890.70 | $21,204.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,757.86 / $19,130.66 / $28,618.31
| Facility | | $11,757.86 | $19,130.66 | $28,618.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,632.39 / $18,110.68 / $30,813.23
| Facility | | $14,632.39 | $18,110.68 | $30,813.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,091.35 / $21,005.11 / $34,382.33
| Facility | | $13,091.35 | $21,005.11 | $34,382.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $172.96 / $10,916.24 / $17,296.37
| Facility | | $172.96 | $10,916.24 | $17,296.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,897.32 / $20,752.15 / $24,388.98
| Facility | | $14,897.32 | $20,752.15 | $24,388.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,444.82 / $22,135.20 / $27,903.22
| Facility | | $13,444.82 | $22,135.20 | $27,903.22 |