- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,960.00 / $23,860.90 / $42,019.10
| Facility | | $14,960.00 | $23,860.90 | $42,019.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,030.55 / $20,266.04 / $29,498.78
| Facility | | $8,030.55 | $20,266.04 | $29,498.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,832.99 / $18,553.16 / $31,080.87
| Facility | | $13,832.99 | $18,553.16 | $31,080.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,065.32 / $16,130.79 / $19,851.05
| Facility | | $11,065.32 | $16,130.79 | $19,851.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,598.40 / $17,926.68 / $27,606.74
| Facility | | $6,598.40 | $17,926.68 | $27,606.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,949.43 / $19,539.46 / $26,564.96
| Facility | | $13,949.43 | $19,539.46 | $26,564.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,945.60 / $38,933.69
| Facility | | $3,775.00 | $14,945.60 | $38,933.69 |