- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,707.75 / $14,320.90 / $23,947.10
| Facility | | $6,707.75 | $14,320.90 | $23,947.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,345.23 / $24,644.14 / $31,567.62
| Facility | | $16,345.23 | $24,644.14 | $31,567.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $19,217.87 / $30,727.35
| Facility | | $14,646.00 | $19,217.87 | $30,727.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,774.38 / $20,703.24 / $43,415.34
| Facility | | $10,774.38 | $20,703.24 | $43,415.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,207.79 / $9,207.79 / $9,207.79
| Facility | | $9,207.79 | $9,207.79 | $9,207.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,199.29 / $20,566.52 / $30,734.94
| Facility | | $15,199.29 | $20,566.52 | $30,734.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,531.23 / $26,433.95
| Facility | | $4,870.00 | $16,531.23 | $26,433.95 |