- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,424.10 / $21,411.20 / $37,705.10
| Facility | | $13,424.10 | $21,411.20 | $37,705.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,878.03 / $18,271.84 / $26,562.02
| Facility | | $7,878.03 | $18,271.84 | $26,562.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,412.78 / $16,648.34 / $27,889.87
| Facility | | $12,412.78 | $16,648.34 | $27,889.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,265.61 / $14,964.99 / $18,416.38
| Facility | | $10,265.61 | $14,964.99 | $18,416.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $16,423.33 / $24,858.34
| Facility | | $6,409.00 | $16,423.33 | $24,858.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,560.69 / $17,608.79 / $23,920.27
| Facility | | $12,560.69 | $17,608.79 | $23,920.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,411.17 / $34,936.44
| Facility | | $3,775.00 | $13,411.17 | $34,936.44 |