- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,693.43 / $14,290.30 / $23,896.00
| Facility | | $6,693.43 | $14,290.30 | $23,896.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,648.31 / $24,704.94 / $32,034.70
| Facility | | $16,648.31 | $24,704.94 | $32,034.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,646.00 / $19,176.84 / $30,661.74
| Facility | | $14,646.00 | $19,176.84 | $30,661.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,751.38 / $20,659.03 / $43,322.64
| Facility | | $10,751.38 | $20,659.03 | $43,322.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,827.61 / $7,827.61 / $9,118.78
| Facility | | $7,827.61 | $7,827.61 | $9,118.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,166.84 / $20,522.59 / $30,669.31
| Facility | | $15,166.84 | $20,522.59 | $30,669.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,495.93 / $26,377.51
| Facility | | $4,870.00 | $16,495.93 | $26,377.51 |