- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,621.30 / $22,136.20 / $26,728.90
| Facility | | $11,621.30 | $22,136.20 | $26,728.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $19,988.55 / $34,396.19
| Facility | | $6,916.00 | $19,988.55 | $34,396.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,664.25 / $19,088.95 / $22,908.30
| Facility | | $16,664.25 | $19,088.95 | $22,908.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,496.31 / $17,328.30 / $22,591.80
| Facility | | $12,496.31 | $17,328.30 | $22,591.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,335.47 / $23,004.12 / $35,278.78
| Facility | | $12,335.47 | $23,004.12 | $35,278.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,632.58 / $19,668.79 / $29,861.57
| Facility | | $13,632.58 | $19,668.79 | $29,861.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,225.84 / $26,254.73
| Facility | | $3,775.00 | $18,225.84 | $26,254.73 |