- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,086.29 / $14,363.70 / $23,291.50
| Facility | | $9,086.29 | $14,363.70 | $23,291.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,430.20 / $13,977.03 / $32,175.07
| Facility | | $11,430.20 | $13,977.03 | $32,175.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,684.00 / $12,144.75 / $22,934.34
| Facility | | $1,684.00 | $12,144.75 | $22,934.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,942.91 / $15,507.00 / $26,676.98
| Facility | | $10,942.91 | $15,507.00 | $26,676.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,284.38 / $22,193.75 / $26,046.25
| Facility | | $15,284.38 | $22,193.75 | $26,046.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,147.40 / $13,692.97 / $27,554.50
| Facility | | $10,147.40 | $13,692.97 | $27,554.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $11,672.59 / $23,896.97
| Facility | | $5,693.00 | $11,672.59 | $23,896.97 |