- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,743.94 / $15,654.10 / $25,941.30
| Facility | | $7,743.94 | $15,654.10 | $25,941.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,929.54 / $26,606.20 / $34,500.06
| Facility | | $17,929.54 | $26,606.20 | $34,500.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $20,818.22 / $33,286.14
| Facility | | $14,646.00 | $20,818.22 | $33,286.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,671.61 / $22,427.28 / $47,030.71
| Facility | | $11,671.61 | $22,427.28 | $47,030.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,465.00 / $22,279.18 / $33,294.36
| Facility | | $16,465.00 | $22,279.18 | $33,294.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,763.00 / $28,635.21
| Facility | | $4,870.00 | $16,763.00 | $28,635.21 |