- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,762.70 / $21,951.20 / $38,656.00
| Facility | | $13,762.70 | $21,951.20 | $38,656.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,502.31 / $17,411.34 / $25,299.85
| Facility | | $7,502.31 | $17,411.34 | $25,299.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,725.83 / $17,068.21 / $28,593.24
| Facility | | $12,725.83 | $17,068.21 | $28,593.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,915.02 / $14,398.95 / $17,787.43
| Facility | | $9,915.02 | $14,398.95 | $17,787.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,154.69 / $24,118.65
| Facility | | $6,409.00 | $15,154.69 | $24,118.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,484.26 / $17,257.08 / $23,464.80
| Facility | | $12,484.26 | $17,257.08 | $23,464.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,749.39 / $37,567.79
| Facility | | $3,775.00 | $13,749.39 | $37,567.79 |