- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,502.50 / $23,814.80 / $28,755.80
| Facility | | $12,502.50 | $23,814.80 | $28,755.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,504.30 / $36,912.37
| Facility | | $6,916.00 | $21,504.30 | $36,912.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,850.14 / $20,124.64 / $24,369.82
| Facility | | $17,850.14 | $20,124.64 | $24,369.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,323.11 / $18,011.52 / $23,698.40
| Facility | | $12,323.11 | $18,011.52 | $23,698.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,815.16 / $22,095.48 / $33,116.04
| Facility | | $12,815.16 | $22,095.48 | $33,116.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,170.08 / $19,113.72 / $25,314.35
| Facility | | $14,170.08 | $19,113.72 | $25,314.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,607.91 / $28,245.65
| Facility | | $3,775.00 | $19,607.91 | $28,245.65 |