- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,091.80 / $20,881.09 / $36,771.69
| Facility | | $13,091.80 | $20,881.09 | $36,771.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,822.48 / $17,810.32 / $25,891.10
| Facility | | $6,822.48 | $17,810.32 | $25,891.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,105.48 / $16,236.18 / $27,199.40
| Facility | | $12,105.48 | $16,236.18 | $27,199.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,515.37 / $15,033.10 / $18,864.46
| Facility | | $10,515.37 | $15,033.10 | $18,864.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,594.24 / $16,004.17 / $24,230.46
| Facility | | $6,594.24 | $16,004.17 | $24,230.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,243.43 / $17,161.33 / $23,316.09
| Facility | | $12,243.43 | $17,161.33 | $23,316.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,079.15 / $34,071.53
| Facility | | $3,775.00 | $13,079.15 | $34,071.53 |