- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,691.30 / $24,174.30 / $29,189.90
| Facility | | $12,691.30 | $24,174.30 | $29,189.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $21,828.95 / $35,919.50
| Facility | | $12,397.00 | $21,828.95 | $35,919.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,104.12 / $20,610.43 / $23,777.08
| Facility | | $18,104.12 | $20,610.43 | $23,777.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,021.38 / $20,715.75 / $27,621.00
| Facility | | $13,021.38 | $20,715.75 | $27,621.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,833.00 / $23,144.21 / $34,368.08
| Facility | | $12,833.00 | $23,144.21 | $34,368.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,462.70 / $19,998.34 / $28,737.15
| Facility | | $14,462.70 | $19,998.34 | $28,737.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,328.41 / $30,687.44
| Facility | | $3,775.00 | $21,328.41 | $30,687.44 |