- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,628.70 / $16,952.59 / $29,853.50
| Facility | | $10,628.70 | $16,952.59 | $29,853.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,271.60 / $11,271.60 / $11,271.60
| Facility | | $11,271.60 | $11,271.60 | $11,271.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $14,422.38 / $20,966.00
| Facility | | $6,600.00 | $14,422.38 | $20,966.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,827.98 / $13,181.54 / $22,082.17
| Facility | | $9,827.98 | $13,181.54 | $22,082.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,555.04 / $12,097.20 / $15,347.67
| Facility | | $8,555.04 | $12,097.20 | $15,347.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,144.19 / $12,822.34 / $19,621.25
| Facility | | $6,144.19 | $12,822.34 | $19,621.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,914.44 / $13,887.50 / $18,880.81
| Facility | | $9,914.44 | $13,887.50 | $18,880.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,618.47 / $27,661.39
| Facility | | $3,775.00 | $10,618.47 | $27,661.39 |