- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,214.30 / $19,481.59 / $34,307.10
| Facility | | $12,214.30 | $19,481.59 | $34,307.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $15,853.07 / $23,054.28
| Facility | | $6,746.00 | $15,853.07 | $23,054.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,294.14 / $15,147.99 / $25,376.42
| Facility | | $11,294.14 | $15,147.99 | $25,376.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,694.83 / $12,785.85 / $15,598.43
| Facility | | $8,694.83 | $12,785.85 | $15,598.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $14,401.93 / $21,567.68
| Facility | | $6,409.00 | $14,401.93 | $21,567.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,897.95 / $15,420.81 / $20,982.77
| Facility | | $10,897.95 | $15,420.81 | $20,982.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,202.55 / $31,787.97
| Facility | | $3,775.00 | $12,202.55 | $31,787.97 |