- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,923.90 / $19,018.40 / $33,491.40
| Facility | | $11,923.90 | $19,018.40 | $33,491.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $16,729.95 / $24,480.35
| Facility | | $6,746.00 | $16,729.95 | $24,480.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,025.61 / $14,787.83 / $24,773.07
| Facility | | $11,025.61 | $14,787.83 | $24,773.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,846.07 / $13,810.50 / $15,869.74
| Facility | | $8,846.07 | $13,810.50 | $15,869.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,267.19 / $22,760.65
| Facility | | $6,409.00 | $15,267.19 | $22,760.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.75 / $16,299.32 / $22,167.07
| Facility | | $11,500.75 | $16,299.32 | $22,167.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,912.42 / $31,032.17
| Facility | | $3,775.00 | $11,912.42 | $31,032.17 |