- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,725.20 / $18,701.30 / $32,933.10
| Facility | | $11,725.20 | $18,701.30 | $32,933.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,325.36 / $16,012.51 / $23,277.60
| Facility | | $8,325.36 | $16,012.51 | $23,277.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,841.80 / $14,541.30 / $24,360.08
| Facility | | $10,841.80 | $14,541.30 | $24,360.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,517.59 / $14,399.55 / $19,117.28
| Facility | | $9,517.59 | $14,399.55 | $19,117.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $14,338.74 / $21,784.58
| Facility | | $6,600.00 | $14,338.74 | $21,784.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,007.55 / $15,418.66 / $20,962.50
| Facility | | $11,007.55 | $15,418.66 | $20,962.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,206.10 / $16,501.28 / $23,140.00
| Facility | | $6,206.10 | $16,501.28 | $23,140.00 |