- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,118.69 / $17,844.80 / $29,626.50
| Facility | | $13,118.69 | $17,844.80 | $29,626.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,976.00 / $9,504.00 / $30,631.68
| Facility | | $5,976.00 | $9,504.00 | $30,631.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,039.67 / $16,538.07 / $28,015.84
| Facility | | $11,039.67 | $16,538.07 | $28,015.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,487.18 / $19,882.58 / $31,279.26
| Facility | | $15,487.18 | $19,882.58 | $31,279.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,196.23 / $19,108.45 / $49,365.03
| Facility | | $9,196.23 | $19,108.45 | $49,365.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $18,244.06 / $25,641.12
| Facility | | $9,226.00 | $18,244.06 | $25,641.12 |