- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,726.70 / $18,703.80 / $32,937.50
| Facility | | $11,726.70 | $18,703.80 | $32,937.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,604.62 / $15,806.92 / $22,978.74
| Facility | | $6,604.62 | $15,806.92 | $22,978.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,843.24 / $14,543.23 / $24,363.30
| Facility | | $10,843.24 | $14,543.23 | $24,363.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,924.91 / $12,208.35 / $14,425.00
| Facility | | $7,924.91 | $12,208.35 | $14,425.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $13,984.79 / $21,504.89
| Facility | | $6,409.00 | $13,984.79 | $21,504.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,866.22 / $15,220.70 / $20,693.37
| Facility | | $10,866.22 | $15,220.70 | $20,693.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,715.38 / $30,518.88
| Facility | | $3,775.00 | $11,715.38 | $30,518.88 |