- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,507.84 / $11,477.00 / $19,663.30
| Facility | | $5,507.84 | $11,477.00 | $19,663.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,362.80 / $21,281.52 / $29,480.68
| Facility | | $14,362.80 | $21,281.52 | $29,480.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,480.37 / $17,598.37 / $25,230.69
| Facility | | $12,480.37 | $17,598.37 | $25,230.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,847.01 / $16,999.74 / $35,648.99
| Facility | | $8,847.01 | $16,999.74 | $35,648.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,480.37 / $17,648.00 / $25,236.92
| Facility | | $12,480.37 | $17,648.00 | $25,236.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $14,498.13 / $22,223.77
| Facility | | $4,870.00 | $14,498.13 | $22,223.77 |