- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,825.00 / $24,429.10 / $29,497.50
| Facility | | $12,825.00 | $24,429.10 | $29,497.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $22,059.00 / $37,864.53
| Facility | | $6,916.00 | $22,059.00 | $37,864.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,779.36 / $20,573.52 / $24,981.46
| Facility | | $17,779.36 | $20,573.52 | $24,981.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,339.14 / $17,200.59 / $23,264.84
| Facility | | $11,339.14 | $17,200.59 | $23,264.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,265.03 / $22,510.16 / $34,635.60
| Facility | | $13,265.03 | $22,510.16 | $34,635.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,675.56 / $20,340.27 / $26,475.92
| Facility | | $14,675.56 | $20,340.27 | $26,475.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,113.70 / $28,974.24
| Facility | | $3,775.00 | $20,113.70 | $28,974.24 |