- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,003.00 / $17,549.50 / $30,904.80
| Facility | | $11,003.00 | $17,549.50 | $30,904.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,371.91 / $14,017.16 / $20,513.56
| Facility | | $6,371.91 | $14,017.16 | $20,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,174.06 / $13,645.71 / $22,859.75
| Facility | | $10,174.06 | $13,645.71 | $22,859.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,714.10 / $11,245.46 / $13,839.01
| Facility | | $7,714.10 | $11,245.46 | $13,839.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,034.26 / $12,287.69 / $19,270.21
| Facility | | $6,034.26 | $12,287.69 | $19,270.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,737.06 / $13,639.04 / $18,543.02
| Facility | | $9,737.06 | $13,639.04 | $18,543.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,992.38 / $28,635.44
| Facility | | $3,775.00 | $10,992.38 | $28,635.44 |