- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,258.80 / $23,350.50 / $28,195.10
| Facility | | $12,258.80 | $23,350.50 | $28,195.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,085.05 / $36,192.73
| Facility | | $6,916.00 | $21,085.05 | $36,192.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,522.12 / $19,785.38 / $23,907.54
| Facility | | $17,522.12 | $19,785.38 | $23,907.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,118.02 / $16,822.98 / $21,857.00
| Facility | | $11,118.02 | $16,822.98 | $21,857.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,421.21 / $20,980.50 / $32,115.69
| Facility | | $12,421.21 | $20,980.50 | $32,115.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,728.66 / $19,026.68 / $24,395.50
| Facility | | $13,728.66 | $19,026.68 | $24,395.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,225.64 / $27,694.97
| Facility | | $3,775.00 | $19,225.64 | $27,694.97 |