- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,843.60 / $23,675.20 / $41,692.00
| Facility | | $14,843.60 | $23,675.20 | $41,692.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,926.39 / $19,293.47 / $28,343.49
| Facility | | $7,926.39 | $19,293.47 | $28,343.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,725.29 / $18,408.71 / $30,838.89
| Facility | | $13,725.29 | $18,408.71 | $30,838.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,313.73 / $15,035.14 / $18,502.71
| Facility | | $10,313.73 | $15,035.14 | $18,502.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $17,676.43 / $26,248.24
| Facility | | $6,409.00 | $17,676.43 | $26,248.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,262.99 / $18,873.41 / $25,667.84
| Facility | | $13,262.99 | $18,873.41 | $25,667.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,829.24 / $38,630.57
| Facility | | $3,775.00 | $14,829.24 | $38,630.57 |