- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,550.20 / $13,984.50 / $23,384.60
| Facility | | $6,550.20 | $13,984.50 | $23,384.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,592.18 / $24,621.65 / $31,926.70
| Facility | | $16,592.18 | $24,621.65 | $31,926.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $18,766.49 / $30,005.64
| Facility | | $14,646.00 | $18,766.49 | $30,005.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,521.32 / $20,216.97 / $42,395.62
| Facility | | $10,521.32 | $20,216.97 | $42,395.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,842.30 / $20,083.46 / $30,013.05
| Facility | | $14,842.30 | $20,083.46 | $30,013.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,142.95 / $25,813.08
| Facility | | $4,870.00 | $16,142.95 | $25,813.08 |