- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,789.71 / $13,602.50 / $24,239.70
| Facility | | $6,789.71 | $13,602.50 | $24,239.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,387.56 / $22,550.94 / $29,241.63
| Facility | | $15,387.56 | $22,550.94 | $29,241.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $19,452.68 / $31,102.79
| Facility | | $14,646.00 | $19,452.68 | $31,102.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,906.03 / $20,956.18 / $43,945.80
| Facility | | $10,906.03 | $20,956.18 | $43,945.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,385.00 / $20,817.81 / $31,110.46
| Facility | | $15,385.00 | $20,817.81 | $31,110.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,623.99 / $26,756.93
| Facility | | $4,870.00 | $16,623.99 | $26,756.93 |