- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,415.00 / $21,743.30 / $26,254.50
| Facility | | $11,415.00 | $21,743.30 | $26,254.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $19,633.80 / $33,701.65
| Facility | | $6,916.00 | $19,633.80 | $33,701.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,479.20 / $18,537.68 / $22,087.92
| Facility | | $14,479.20 | $18,537.68 | $22,087.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,479.65 / $14,796.80 / $20,450.28
| Facility | | $9,479.65 | $14,796.80 | $20,450.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,680.56 / $19,647.40 / $30,177.48
| Facility | | $11,680.56 | $19,647.40 | $30,177.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,900.12 / $17,879.52 / $22,572.64
| Facility | | $12,900.12 | $17,879.52 | $22,572.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,902.37 / $25,788.77
| Facility | | $3,775.00 | $17,902.37 | $25,788.77 |