- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,424.10 / $17,225.40 / $28,598.20
| Facility | | $13,424.10 | $17,225.40 | $28,598.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,952.00 / $11,952.00 / $21,355.92
| Facility | | $11,952.00 | $11,952.00 | $21,355.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,344.25 / $15,650.02 / $26,450.85
| Facility | | $10,344.25 | $15,650.02 | $26,450.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,847.75 / $18,372.87 / $26,798.00
| Facility | | $14,847.75 | $18,372.87 | $26,798.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,877.04 / $18,445.23 / $45,713.89
| Facility | | $8,877.04 | $18,445.23 | $45,713.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $17,610.84 / $24,751.17
| Facility | | $9,226.00 | $17,610.84 | $24,751.17 |