- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,831.25 / $18,726.59 / $22,611.90
| Facility | | $9,831.25 | $18,726.59 | $22,611.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,909.75 / $28,557.14
| Facility | | $6,916.00 | $16,909.75 | $28,557.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,927.60 / $15,960.28 / $19,744.46
| Facility | | $12,927.60 | $15,960.28 | $19,744.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,694.83 / $13,007.03 / $17,167.73
| Facility | | $8,694.83 | $13,007.03 | $17,167.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,832.62 / $16,493.72 / $25,315.95
| Facility | | $9,832.62 | $16,493.72 | $25,315.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,829.47 / $14,615.24 / $18,699.09
| Facility | | $10,829.47 | $14,615.24 | $18,699.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,522.00 / $22,210.76
| Facility | | $3,775.00 | $16,522.00 | $22,210.76 |