- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $19,498.45 / $39,810.72
| Facility | | $16,982.44 | $19,498.45 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $17,378.01 / $25,118.86
| Facility | | $10,471.29 | $17,378.01 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $15,488.17 / $22,387.21
| Facility | | $12,882.50 | $15,488.17 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,022.64 / $15,488.17
| Facility | | $10,000.00 | $12,022.64 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $15,848.93 / $25,118.86
| Facility | | $12,589.25 | $15,848.93 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $13,489.63 / $17,378.01
| Facility | | $9,332.54 | $13,489.63 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $15,848.93 / $19,498.45
| Facility | | $12,302.69 | $15,848.93 | $19,498.45 |