- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,437.50 / $17,976.59 / $21,706.30
| Facility | | $9,437.50 | $17,976.59 | $21,706.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,232.50 / $27,863.28
| Facility | | $6,916.00 | $16,232.50 | $27,863.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,725.66 / $15,694.18 / $19,274.96
| Facility | | $13,725.66 | $15,694.18 | $19,274.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,517.59 / $14,399.55 / $19,199.40
| Facility | | $9,517.59 | $14,399.55 | $19,199.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,734.45 / $16,785.00 / $25,446.96
| Facility | | $9,734.45 | $16,785.00 | $25,446.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,991.65 / $14,844.63 / $19,701.75
| Facility | | $10,991.65 | $14,844.63 | $19,701.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,762.00 / $16,779.12 / $20,460.50
| Facility | | $9,762.00 | $16,779.12 | $20,460.50 |