- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,105.50 / $17,713.00 / $31,192.70
| Facility | | $11,105.50 | $17,713.00 | $31,192.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $14,477.73 / $21,057.81
| Facility | | $6,600.00 | $14,477.73 | $21,057.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,268.84 / $13,772.83 / $23,072.70
| Facility | | $10,268.84 | $13,772.83 | $23,072.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,708.58 / $11,984.67 / $15,623.10
| Facility | | $8,708.58 | $11,984.67 | $15,623.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,310.42 / $12,609.97 / $20,068.73
| Facility | | $6,310.42 | $12,609.97 | $20,068.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,182.67 / $14,259.73 / $19,337.98
| Facility | | $10,182.67 | $14,259.73 | $19,337.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,094.78 / $28,902.20
| Facility | | $3,775.00 | $11,094.78 | $28,902.20 |