- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,422.50 / $17,948.00 / $21,671.80
| Facility | | $9,422.50 | $17,948.00 | $21,671.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,206.70 / $29,424.73
| Facility | | $6,916.00 | $16,206.70 | $29,424.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,705.50 / $15,479.50 / $19,153.93
| Facility | | $13,705.50 | $15,479.50 | $19,153.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,680.15 / $13,659.48 / $18,487.81
| Facility | | $9,680.15 | $13,659.48 | $18,487.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,577.02 / $18,173.75 / $27,159.20
| Facility | | $10,577.02 | $18,173.75 | $27,159.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,662.19 / $15,602.63 / $21,980.71
| Facility | | $11,662.19 | $15,602.63 | $21,980.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,777.50 / $21,287.31
| Facility | | $3,775.00 | $14,777.50 | $21,287.31 |