- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,696.30 / $22,279.00 / $26,901.40
| Facility | | $11,696.30 | $22,279.00 | $26,901.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $20,117.55 / $34,532.01
| Facility | | $6,916.00 | $20,117.55 | $34,532.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,761.53 / $19,002.46 / $22,840.72
| Facility | | $16,761.53 | $19,002.46 | $22,840.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,804.09 / $15,995.30 / $20,779.20
| Facility | | $10,804.09 | $15,995.30 | $20,779.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,866.97 / $20,085.90 / $30,662.85
| Facility | | $11,866.97 | $20,085.90 | $30,662.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,107.60 / $18,119.65 / $23,355.28
| Facility | | $13,107.60 | $18,119.65 | $23,355.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,343.46 / $26,424.17
| Facility | | $3,775.00 | $18,343.46 | $26,424.17 |