- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,516.25 / $16,221.80 / $19,587.40
| Facility | | $8,516.25 | $16,221.80 | $19,587.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,647.95 / $24,613.42
| Facility | | $6,916.00 | $14,647.95 | $24,613.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,486.00 / $13,988.71 / $17,844.62
| Facility | | $12,486.00 | $13,988.71 | $17,844.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,419.86 / $11,864.31 / $15,723.40
| Facility | | $8,419.86 | $11,864.31 | $15,723.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,500.44 / $14,731.08 / $22,407.84
| Facility | | $8,500.44 | $14,731.08 | $22,407.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,333.93 / $13,100.52 / $17,128.86
| Facility | | $9,333.93 | $13,100.52 | $17,128.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,356.21 / $19,239.91
| Facility | | $3,775.00 | $13,356.21 | $19,239.91 |