- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,275.00 / $21,173.40 / $37,286.40
| Facility | | $13,275.00 | $21,173.40 | $37,286.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $18,313.78 / $26,705.35
| Facility | | $6,746.00 | $18,313.78 | $26,705.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,274.93 / $16,463.45 / $27,580.12
| Facility | | $12,274.93 | $16,463.45 | $27,580.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,044.48 / $14,731.20 / $18,019.68
| Facility | | $10,044.48 | $14,731.20 | $18,019.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $16,199.78 / $24,992.48
| Facility | | $6,409.00 | $16,199.78 | $24,992.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,628.47 / $17,689.14 / $24,049.35
| Facility | | $12,628.47 | $17,689.14 | $24,049.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,262.22 / $34,548.44
| Facility | | $3,775.00 | $13,262.22 | $34,548.44 |