- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,112.50 / $15,452.70 / $18,658.80
| Facility | | $8,112.50 | $15,452.70 | $18,658.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $13,953.50 / $23,368.61
| Facility | | $6,916.00 | $13,953.50 | $23,368.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,917.58 / $13,325.51 / $17,261.36
| Facility | | $11,917.58 | $13,325.51 | $17,261.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,730.14 / $11,075.50 / $14,333.00
| Facility | | $7,730.14 | $11,075.50 | $14,333.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,106.80 / $13,809.88 / $20,894.75
| Facility | | $8,106.80 | $13,809.88 | $20,894.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,861.87 / $12,399.63 / $15,972.24
| Facility | | $8,861.87 | $12,399.63 | $15,972.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,723.00 / $18,327.75
| Facility | | $3,775.00 | $12,723.00 | $18,327.75 |