- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,885.00 / $24,543.30 / $29,635.50
| Facility | | $12,885.00 | $24,543.30 | $29,635.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $22,162.20 / $38,041.67
| Facility | | $6,916.00 | $22,162.20 | $38,041.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,313.40 / $20,655.18 / $24,466.22
| Facility | | $16,313.40 | $20,655.18 | $24,466.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,925.54 / $17,323.00 / $23,010.98
| Facility | | $10,925.54 | $17,323.00 | $23,010.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,123.36 / $21,803.48 / $33,956.18
| Facility | | $13,123.36 | $21,803.48 | $33,956.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,515.42 / $19,846.71 / $25,351.50
| Facility | | $14,515.42 | $19,846.71 | $25,351.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,207.80 / $29,109.79
| Facility | | $3,775.00 | $20,207.80 | $29,109.79 |