- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,061.79 / $16,986.00 / $29,890.50
| Facility | | $10,061.79 | $16,986.00 | $29,890.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $11,934.00 / $17,957.45
| Facility | | $5,256.00 | $11,934.00 | $17,957.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,147.16 / $17,930.40 / $29,646.91
| Facility | | $12,147.16 | $17,930.40 | $29,646.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,152.81 / $15,656.97 / $21,619.47
| Facility | | $9,152.81 | $15,656.97 | $21,619.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,956.35 / $31,956.35 / $37,503.49
| Facility | | $31,956.35 | $31,956.35 | $37,503.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $14,803.18 / $21,144.65
| Facility | | $1,787.00 | $14,803.18 | $21,144.65 |