- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,427.47 / $11,227.00 / $19,376.40
| Facility | | $5,427.47 | $11,227.00 | $19,376.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,378.87 / $19,607.14 / $25,424.43
| Facility | | $13,378.87 | $19,607.14 | $25,424.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,298.26 / $17,341.59 / $24,862.55
| Facility | | $12,298.26 | $17,341.59 | $24,862.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,717.92 / $16,751.68 / $35,128.83
| Facility | | $8,717.92 | $16,751.68 | $35,128.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,298.26 / $17,648.00 / $24,868.68
| Facility | | $12,298.26 | $17,648.00 | $24,868.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $14,286.58 / $21,899.50
| Facility | | $4,870.00 | $14,286.58 | $21,899.50 |