- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,438.75 / $17,978.90 / $21,709.10
| Facility | | $9,438.75 | $17,978.90 | $21,709.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,234.65 / $27,565.70
| Facility | | $6,916.00 | $16,234.65 | $27,565.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,926.80 / $15,417.26 / $19,177.38
| Facility | | $11,926.80 | $15,417.26 | $19,177.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,924.91 / $12,578.30 / $16,571.70
| Facility | | $7,924.91 | $12,578.30 | $16,571.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,498.34 / $15,971.88 / $24,454.05
| Facility | | $9,498.34 | $15,971.88 | $24,454.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,453.50 / $14,488.51 / $18,466.28
| Facility | | $10,453.50 | $14,488.51 | $18,466.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,862.39 / $21,324.02
| Facility | | $3,775.00 | $15,862.39 | $21,324.02 |