- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,395.00 / $17,895.59 / $21,608.50
| Facility | | $9,395.00 | $17,895.59 | $21,608.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,159.40 / $27,448.20
| Facility | | $6,916.00 | $16,159.40 | $27,448.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,072.60 / $15,356.72 / $19,114.20
| Facility | | $12,072.60 | $15,356.72 | $19,114.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,069.27 / $12,529.00 / $16,501.06
| Facility | | $8,069.27 | $12,529.00 | $16,501.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,458.57 / $15,897.84 / $24,462.00
| Facility | | $9,458.57 | $15,897.84 | $24,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,408.94 / $14,402.50 / $18,699.09
| Facility | | $10,408.94 | $14,402.50 | $18,699.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,734.37 / $21,225.18
| Facility | | $3,775.00 | $14,734.37 | $21,225.18 |