- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,753.71 / $11,691.10 / $20,541.09
| Facility | | $5,753.71 | $11,691.10 | $20,541.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,795.75 / $20,824.87 / $28,057.01
| Facility | | $13,795.75 | $20,824.87 | $28,057.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,037.49 / $17,647.00 / $26,357.00
| Facility | | $13,037.49 | $17,647.00 | $26,357.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,241.94 / $17,758.61 / $37,240.37
| Facility | | $9,241.94 | $17,758.61 | $37,240.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,630.93 / $7,893.86 / $8,971.68
| Facility | | $6,630.93 | $7,893.86 | $8,971.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,037.49 / $17,648.00 / $26,363.50
| Facility | | $13,037.49 | $17,648.00 | $26,363.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $15,145.33 / $23,215.85
| Facility | | $4,870.00 | $15,145.33 | $23,215.85 |