- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,784.30 / $20,390.70 / $35,908.00
| Facility | | $12,784.30 | $20,390.70 | $35,908.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $18,729.82 / $26,662.03
| Facility | | $6,746.00 | $18,729.82 | $26,662.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,821.15 / $15,854.83 / $26,560.55
| Facility | | $11,821.15 | $15,854.83 | $26,560.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,059.17 / $14,100.90 / $17,895.81
| Facility | | $9,059.17 | $14,100.90 | $17,895.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,985.07 / $25,981.83
| Facility | | $6,409.00 | $15,985.07 | $25,981.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,480.75 / $18,481.00 / $25,337.75
| Facility | | $13,480.75 | $18,481.00 | $25,337.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,771.95 / $33,271.26
| Facility | | $3,775.00 | $12,771.95 | $33,271.26 |