- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,987.70 / $20,715.20 / $36,479.40
| Facility | | $12,987.70 | $20,715.20 | $36,479.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $17,671.87 / $25,689.83
| Facility | | $6,746.00 | $17,671.87 | $25,689.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,009.27 / $16,107.14 / $26,983.22
| Facility | | $12,009.27 | $16,107.14 | $26,983.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,591.71 / $13,686.75 / $16,126.91
| Facility | | $8,591.71 | $13,686.75 | $16,126.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,838.38 / $24,042.10
| Facility | | $6,409.00 | $15,838.38 | $24,042.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,148.25 / $17,016.48 / $23,134.83
| Facility | | $12,148.25 | $17,016.48 | $23,134.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,874.39 / $18,278.16 / $25,631.76
| Facility | | $6,874.39 | $18,278.16 | $25,631.76 |