- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,369.00 / $17,270.00 / $27,588.90
| Facility | | $8,369.00 | $17,270.00 | $27,588.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,737.54 / $27,763.62 / $37,405.48
| Facility | | $18,737.54 | $27,763.62 | $37,405.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $22,140.45 / $35,400.24
| Facility | | $14,648.00 | $22,140.45 | $35,400.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,412.91 / $23,851.70 / $50,017.77
| Facility | | $12,412.91 | $23,851.70 | $50,017.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,271.48 / $10,271.48 / $10,343.79
| Facility | | $10,271.48 | $10,271.48 | $10,343.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,510.74 / $23,694.19 / $35,408.98
| Facility | | $17,510.74 | $23,694.19 | $35,408.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,960.93 / $17,332.00 / $32,881.92
| Facility | | $7,960.93 | $17,332.00 | $32,881.92 |