- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,041.30 / $22,936.20 / $27,694.90
| Facility | | $12,041.30 | $22,936.20 | $27,694.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $20,710.95 / $35,335.66
| Facility | | $6,916.00 | $20,710.95 | $35,335.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,149.61 / $19,409.30 / $23,218.82
| Facility | | $17,149.61 | $19,409.30 | $23,218.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,065.32 / $16,540.83 / $21,414.80
| Facility | | $11,065.32 | $16,540.83 | $21,414.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,127.94 / $20,629.05 / $31,379.40
| Facility | | $12,127.94 | $20,629.05 | $31,379.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,400.03 / $18,572.39 / $23,986.84
| Facility | | $13,400.03 | $18,572.39 | $23,986.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,884.53 / $27,203.59
| Facility | | $3,775.00 | $18,884.53 | $27,203.59 |