- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,985.00 / $19,019.40 / $22,965.50
| Facility | | $9,985.00 | $19,019.40 | $22,965.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $17,174.20 / $29,379.67
| Facility | | $6,916.00 | $17,174.20 | $29,379.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,008.60 / $16,314.04 / $19,966.56
| Facility | | $13,008.60 | $16,314.04 | $19,966.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,618.07 / $13,380.70 / $17,662.21
| Facility | | $8,618.07 | $13,380.70 | $17,662.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,113.49 / $16,995.27 / $26,063.26
| Facility | | $10,113.49 | $16,995.27 | $26,063.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,141.39 / $15,441.93 / $19,761.59
| Facility | | $11,141.39 | $15,441.93 | $19,761.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,659.68 / $22,558.11
| Facility | | $3,775.00 | $15,659.68 | $22,558.11 |