- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,947.50 / $22,757.60 / $27,479.30
| Facility | | $11,947.50 | $22,757.60 | $27,479.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $20,549.70 / $35,107.99
| Facility | | $6,916.00 | $20,549.70 | $35,107.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,244.20 / $19,278.82 / $23,080.22
| Facility | | $15,244.20 | $19,278.82 | $23,080.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,313.73 / $15,395.20 / $21,105.91
| Facility | | $10,313.73 | $15,395.20 | $21,105.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,049.64 / $20,277.30 / $30,809.95
| Facility | | $12,049.64 | $20,277.30 | $30,809.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,313.69 / $17,812.14 / $22,698.96
| Facility | | $13,313.69 | $17,812.14 | $22,698.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,737.50 / $26,991.79
| Facility | | $3,775.00 | $18,737.50 | $26,991.79 |