- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,652.50 / $26,005.30 / $31,400.80
| Facility | | $13,652.50 | $26,005.30 | $31,400.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $23,482.30 / $32,750.57
| Facility | | $12,397.00 | $23,482.30 | $32,750.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,185.84 / $21,725.24 / $26,550.84
| Facility | | $18,185.84 | $21,725.24 | $26,550.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,356.78 / $18,808.12 / $25,634.40
| Facility | | $12,356.78 | $18,808.12 | $25,634.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,833.00 / $22,019.13 / $32,656.78
| Facility | | $12,833.00 | $22,019.13 | $32,656.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,432.12 / $18,771.82 / $25,973.15
| Facility | | $13,432.12 | $18,771.82 | $25,973.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $22,943.85 / $33,011.75
| Facility | | $3,775.00 | $22,943.85 | $33,011.75 |