- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,856.25 / $16,869.40 / $20,369.40
| Facility | | $8,856.25 | $16,869.40 | $20,369.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $15,232.75 / $24,220.51
| Facility | | $6,916.00 | $15,232.75 | $24,220.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,116.80 / $14,547.19 / $18,335.86
| Facility | | $11,116.80 | $14,547.19 | $18,335.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,714.10 / $11,272.70 / $14,588.20
| Facility | | $7,714.10 | $11,272.70 | $14,588.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,376.19 / $14,986.19 / $22,619.20
| Facility | | $8,376.19 | $14,986.19 | $22,619.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,184.93 / $12,897.16 / $18,572.77
| Facility | | $9,184.93 | $12,897.16 | $18,572.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,889.43 / $20,008.04
| Facility | | $3,775.00 | $13,889.43 | $20,008.04 |