- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,227.50 / $17,576.50 / $21,223.30
| Facility | | $9,227.50 | $17,576.50 | $21,223.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $15,871.30 / $26,133.62
| Facility | | $6,916.00 | $15,871.30 | $26,133.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,675.60 / $15,125.00 / $18,872.16
| Facility | | $12,675.60 | $15,125.00 | $18,872.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,193.01 / $12,124.40 / $15,710.78
| Facility | | $8,193.01 | $12,124.40 | $15,710.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,013.69 / $15,443.89 / $23,183.63
| Facility | | $9,013.69 | $15,443.89 | $23,183.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,910.42 / $13,915.87 / $17,101.61
| Facility | | $9,910.42 | $13,915.87 | $17,101.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,471.67 / $20,846.77
| Facility | | $3,775.00 | $14,471.67 | $20,846.77 |