- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,520.40 / $21,564.80 / $37,975.60
| Facility | | $13,520.40 | $21,564.80 | $37,975.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.80 / $19,291.57 / $27,395.99
| Facility | | $7,495.80 | $19,291.57 | $27,395.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,501.82 / $16,767.75 / $28,089.91
| Facility | | $12,501.82 | $16,767.75 | $28,089.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,625.57 / $16,184.85 / $20,856.14
| Facility | | $11,625.57 | $16,184.85 | $20,856.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $16,532.00 / $27,121.39
| Facility | | $6,409.00 | $16,532.00 | $27,121.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,072.01 / $19,291.57 / $26,449.06
| Facility | | $14,072.01 | $19,291.57 | $26,449.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,507.36 / $36,906.48
| Facility | | $3,775.00 | $13,507.36 | $36,906.48 |