- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,433.80 / $21,779.00 / $26,297.60
| Facility | | $11,433.80 | $21,779.00 | $26,297.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $19,666.05 / $32,460.48
| Facility | | $6,916.00 | $19,666.05 | $32,460.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,252.40 / $18,318.24 / $22,123.46
| Facility | | $14,252.40 | $18,318.24 | $22,123.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,533.49 / $14,681.20 / $19,514.30
| Facility | | $9,533.49 | $14,681.20 | $19,514.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,154.88 / $18,787.43 / $28,796.30
| Facility | | $11,154.88 | $18,787.43 | $28,796.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,309.70 / $17,061.20 / $21,606.73
| Facility | | $12,309.70 | $17,061.20 | $21,606.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,931.78 / $25,831.13
| Facility | | $3,775.00 | $17,931.78 | $25,831.13 |