- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,438.20 / $23,028.70 / $40,553.50
| Facility | | $14,438.20 | $23,028.70 | $40,553.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,114.00 / $21,452.43 / $30,446.90
| Facility | | $10,114.00 | $21,452.43 | $30,446.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,350.49 / $17,906.02 / $29,996.77
| Facility | | $13,350.49 | $17,906.02 | $29,996.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,496.31 / $17,328.30 / $22,418.25
| Facility | | $12,496.31 | $17,328.30 | $22,418.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,199.99 / $18,383.75 / $30,159.27
| Facility | | $7,199.99 | $18,383.75 | $30,159.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,648.23 / $21,452.43 / $29,411.64
| Facility | | $15,648.23 | $21,452.43 | $29,411.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,424.30 / $37,575.68
| Facility | | $3,775.00 | $14,424.30 | $37,575.68 |