- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,773.75 / $16,712.20 / $20,179.59
| Facility | | $8,773.75 | $16,712.20 | $20,179.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $15,090.85 / $25,641.58
| Facility | | $6,916.00 | $15,090.85 | $25,641.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,963.80 / $14,319.62 / $17,057.32
| Facility | | $10,963.80 | $14,319.62 | $17,057.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,782.84 / $11,874.50 / $15,414.97
| Facility | | $7,782.84 | $11,874.50 | $15,414.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,849.64 / $14,846.59 / $22,747.12
| Facility | | $8,849.64 | $14,846.59 | $22,747.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,723.83 / $13,477.19 / $16,546.83
| Facility | | $9,723.83 | $13,477.19 | $16,546.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,760.05 / $19,821.66
| Facility | | $3,775.00 | $13,760.05 | $19,821.66 |