- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,805.00 / $20,581.40 / $24,851.50
| Facility | | $10,805.00 | $20,581.40 | $24,851.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $18,584.59 / $31,900.68
| Facility | | $6,916.00 | $18,584.59 | $31,900.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,401.48 / $17,688.66 / $21,151.30
| Facility | | $15,401.48 | $17,688.66 | $21,151.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,265.61 / $14,964.99 / $19,555.80
| Facility | | $10,265.61 | $14,964.99 | $19,555.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,125.07 / $18,977.70 / $29,178.50
| Facility | | $11,125.07 | $18,977.70 | $29,178.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,274.89 / $16,845.14 / $22,381.94
| Facility | | $12,274.89 | $16,845.14 | $22,381.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,945.70 / $24,410.66
| Facility | | $3,775.00 | $16,945.70 | $24,410.66 |