- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,092.50 / $19,224.20 / $23,212.80
| Facility | | $10,092.50 | $19,224.20 | $23,212.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $17,359.09 / $29,779.92
| Facility | | $6,916.00 | $17,359.09 | $29,779.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,123.80 / $16,536.29 / $20,121.91
| Facility | | $13,123.80 | $16,536.29 | $20,121.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,778.46 / $13,491.20 / $17,902.83
| Facility | | $8,778.46 | $13,491.20 | $17,902.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,246.45 / $17,280.90 / $26,418.33
| Facility | | $10,246.45 | $17,280.90 | $26,418.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,293.18 / $15,758.54 / $20,046.41
| Facility | | $11,293.18 | $15,758.54 | $20,046.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,828.27 / $22,800.98
| Facility | | $3,775.00 | $15,828.27 | $22,800.98 |