- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,685.00 / $20,352.80 / $24,575.50
| Facility | | $10,685.00 | $20,352.80 | $24,575.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $18,378.20 / $31,546.39
| Facility | | $6,916.00 | $18,378.20 | $31,546.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,049.75 / $17,521.64 / $20,977.90
| Facility | | $15,049.75 | $17,521.64 | $20,977.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,044.48 / $14,974.47 / $19,641.59
| Facility | | $10,044.48 | $14,974.47 | $19,641.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,975.93 / $18,870.32 / $29,211.84
| Facility | | $10,975.93 | $18,870.32 | $29,211.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,109.18 / $16,783.28 / $22,329.93
| Facility | | $12,109.18 | $16,783.28 | $22,329.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,757.50 / $24,139.55
| Facility | | $3,775.00 | $16,757.50 | $24,139.55 |