- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,233.20 / $22,701.70 / $39,977.69
| Facility | | $14,233.20 | $22,701.70 | $39,977.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $19,695.91 / $28,867.51
| Facility | | $6,746.00 | $19,695.91 | $28,867.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,160.94 / $17,651.79 / $29,570.87
| Facility | | $13,160.94 | $17,651.79 | $29,570.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,282.79 / $15,006.75 / $18,447.22
| Facility | | $10,282.79 | $15,006.75 | $18,447.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $17,392.03 / $27,015.96
| Facility | | $6,409.00 | $17,392.03 | $27,015.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,650.92 / $19,121.32 / $25,996.48
| Facility | | $13,650.92 | $19,121.32 | $25,996.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,219.50 / $37,042.18
| Facility | | $3,775.00 | $14,219.50 | $37,042.18 |