- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,063.80 / $20,836.50 / $36,693.10
| Facility | | $13,063.80 | $20,836.50 | $36,693.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,996.14 / $17,940.39 / $26,080.18
| Facility | | $7,996.14 | $17,940.39 | $26,080.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,079.63 / $16,201.51 / $27,141.32
| Facility | | $12,079.63 | $16,201.51 | $27,141.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,014.69 / $14,368.40 / $17,966.25
| Facility | | $10,014.69 | $14,368.40 | $17,966.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $16,024.67 / $24,407.41
| Facility | | $6,600.00 | $16,024.67 | $24,407.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,332.84 / $17,275.04 / $23,486.36
| Facility | | $12,332.84 | $17,275.04 | $23,486.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,051.22 / $33,998.78
| Facility | | $3,775.00 | $13,051.22 | $33,998.78 |