- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,952.50 / $17,052.70 / $20,590.80
| Facility | | $8,952.50 | $17,052.70 | $20,590.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $15,398.30 / $25,718.69
| Facility | | $6,916.00 | $15,398.30 | $25,718.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,073.04 / $14,705.29 / $18,474.91
| Facility | | $13,073.04 | $14,705.29 | $18,474.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,965.21 / $12,457.50 / $16,354.80
| Facility | | $8,965.21 | $12,457.50 | $16,354.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,873.24 / $15,914.19 / $23,890.74
| Facility | | $8,873.24 | $15,914.19 | $23,890.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,753.07 / $14,105.85 / $17,606.86
| Facility | | $9,753.07 | $14,105.85 | $17,606.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,040.38 / $20,225.49
| Facility | | $3,775.00 | $14,040.38 | $20,225.49 |