- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,883.40 / $17,358.80 / $30,568.90
| Facility | | $10,883.40 | $17,358.80 | $30,568.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,433.00 / $15,100.83 / $21,707.80
| Facility | | $7,433.00 | $15,100.83 | $21,707.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,063.49 / $13,497.41 / $22,611.31
| Facility | | $10,063.49 | $13,497.41 | $22,611.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,559.64 / $12,354.60 / $15,355.89
| Facility | | $8,559.64 | $12,354.60 | $15,355.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $13,001.18 / $20,691.34
| Facility | | $6,409.00 | $13,001.18 | $20,691.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,724.90 / $14,825.10 / $20,157.99
| Facility | | $10,724.90 | $14,825.10 | $20,157.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,872.91 / $28,324.23
| Facility | | $3,775.00 | $10,872.91 | $28,324.23 |