- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,767.60 / $25,149.00 / $44,287.40
| Facility | | $15,767.60 | $25,149.00 | $44,287.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,026.58 / $21,204.51 / $30,422.02
| Facility | | $9,026.58 | $21,204.51 | $30,422.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,579.71 / $19,554.68 / $32,758.65
| Facility | | $14,579.71 | $19,554.68 | $32,758.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,021.38 / $20,715.75 / $26,699.65
| Facility | | $13,021.38 | $20,715.75 | $26,699.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $18,222.89 / $29,025.27
| Facility | | $6,600.00 | $18,222.89 | $29,025.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,059.85 / $20,787.73 / $28,305.75
| Facility | | $15,059.85 | $20,787.73 | $28,305.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,752.38 / $43,040.60
| Facility | | $3,775.00 | $15,752.38 | $43,040.60 |