- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,218.00 / $14,167.00 / $23,441.50
| Facility | | $7,218.00 | $14,167.00 | $23,441.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,745.68 / $26,333.36 / $34,146.26
| Facility | | $17,745.68 | $26,333.36 | $34,146.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $18,812.08 / $30,078.54
| Facility | | $14,646.00 | $18,812.08 | $30,078.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,546.88 / $20,266.09 / $42,498.63
| Facility | | $10,546.88 | $20,266.09 | $42,498.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,878.36 / $20,132.25 / $30,085.97
| Facility | | $14,878.36 | $20,132.25 | $30,085.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,764.16 / $15,806.00 / $27,528.67
| Facility | | $6,764.16 | $15,806.00 | $27,528.67 |