- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,893.00 / $14,806.70 / $24,404.80
| Facility | | $6,893.00 | $14,806.70 | $24,404.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,888.40 / $25,023.73 / $33,714.08
| Facility | | $16,888.40 | $25,023.73 | $33,714.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $19,869.87 / $31,769.82
| Facility | | $14,646.00 | $19,869.87 | $31,769.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,139.92 / $21,405.62 / $44,888.27
| Facility | | $11,139.92 | $21,405.62 | $44,888.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,922.03 / $8,170.08 / $8,418.52
| Facility | | $7,922.03 | $8,170.08 | $8,418.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,714.95 / $21,264.27 / $31,777.66
| Facility | | $15,714.95 | $21,264.27 | $31,777.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,763.00 / $27,330.76
| Facility | | $4,870.00 | $16,763.00 | $27,330.76 |