- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,405.10 / $16,595.90 / $29,225.40
| Facility | | $10,405.10 | $16,595.90 | $29,225.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $14,577.61 / $21,191.67
| Facility | | $6,600.00 | $14,577.61 | $21,191.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,621.20 / $12,904.20 / $21,617.55
| Facility | | $9,621.20 | $12,904.20 | $21,617.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,084.17 / $11,784.93 / $14,502.90
| Facility | | $8,084.17 | $11,784.93 | $14,502.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,210.32 / $12,971.37 / $19,832.45
| Facility | | $6,210.32 | $12,971.37 | $19,832.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,021.15 / $14,036.98 / $19,084.04
| Facility | | $10,021.15 | $14,036.98 | $19,084.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,395.04 / $27,079.39
| Facility | | $3,775.00 | $10,395.04 | $27,079.39 |