- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,672.30 / $18,617.09 / $32,784.80
| Facility | | $11,672.30 | $18,617.09 | $32,784.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,655.38 / $15,622.32 / $22,710.37
| Facility | | $6,655.38 | $15,622.32 | $22,710.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,792.98 / $14,475.82 / $24,250.37
| Facility | | $10,792.98 | $14,475.82 | $24,250.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,069.27 / $12,160.50 / $14,476.18
| Facility | | $8,069.27 | $12,160.50 | $14,476.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $13,925.18 / $21,253.74
| Facility | | $6,409.00 | $13,925.18 | $21,253.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,739.32 / $15,042.94 / $20,451.70
| Facility | | $10,739.32 | $15,042.94 | $20,451.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,661.07 / $30,377.42
| Facility | | $3,775.00 | $11,661.07 | $30,377.42 |