- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,739.50 / $23,509.20 / $41,399.69
| Facility | | $14,739.50 | $23,509.20 | $41,399.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,017.00 / $20,849.40 / $30,419.76
| Facility | | $10,017.00 | $20,849.40 | $30,419.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,629.08 / $18,279.66 / $30,622.71
| Facility | | $13,629.08 | $18,279.66 | $30,622.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,971.58 / $17,119.00 / $21,476.87
| Facility | | $11,971.58 | $17,119.00 | $21,476.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $18,440.84 / $28,468.65
| Facility | | $6,600.00 | $18,440.84 | $28,468.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,384.95 / $20,149.50 / $27,394.34
| Facility | | $14,384.95 | $20,149.50 | $27,394.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,725.29 / $38,359.76
| Facility | | $3,775.00 | $14,725.29 | $38,359.76 |