- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,007.50 / $19,062.30 / $23,017.30
| Facility | | $10,007.50 | $19,062.30 | $23,017.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $17,212.90 / $27,514.30
| Facility | | $6,916.00 | $17,212.90 | $27,514.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,492.72 / $16,204.12 / $19,999.12
| Facility | | $14,492.72 | $16,204.12 | $19,999.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,203.53 / $13,066.20 / $16,909.20
| Facility | | $9,203.53 | $13,066.20 | $16,909.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,480.95 / $16,396.74 / $24,941.52
| Facility | | $9,480.95 | $16,396.74 | $24,941.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,434.00 / $14,498.47 / $19,065.64
| Facility | | $10,434.00 | $14,498.47 | $19,065.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,694.96 / $22,608.94
| Facility | | $3,775.00 | $15,694.96 | $22,608.94 |