- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,576.27 / $11,330.50 / $19,907.59
| Facility | | $5,576.27 | $11,330.50 | $19,907.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,618.00 / $20,046.56 / $25,994.21
| Facility | | $13,618.00 | $20,046.56 | $25,994.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,635.42 / $17,646.00 / $25,544.16
| Facility | | $12,635.42 | $17,646.00 | $25,544.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,956.92 / $17,210.95 / $36,091.90
| Facility | | $8,956.92 | $17,210.95 | $36,091.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,635.42 / $17,648.00 / $25,550.47
| Facility | | $12,635.42 | $17,648.00 | $25,550.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $14,678.26 / $22,499.88
| Facility | | $4,870.00 | $14,678.26 | $22,499.88 |