- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,203.80 / $23,245.70 / $28,068.60
| Facility | | $12,203.80 | $23,245.70 | $28,068.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $20,990.45 / $36,030.35
| Facility | | $6,916.00 | $20,990.45 | $36,030.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,448.12 / $20,022.43 / $24,335.84
| Facility | | $17,448.12 | $20,022.43 | $24,335.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,020.63 / $16,614.36 / $21,909.44
| Facility | | $11,020.63 | $16,614.36 | $21,909.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,501.98 / $21,049.26 / $32,330.69
| Facility | | $12,501.98 | $21,049.26 | $32,330.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,820.56 / $18,790.74 / $24,514.38
| Facility | | $13,820.56 | $18,790.74 | $24,514.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,139.39 / $27,570.71
| Facility | | $3,775.00 | $19,139.39 | $27,570.71 |