- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,866.30 / $17,331.59 / $30,520.90
| Facility | | $10,866.30 | $17,331.59 | $30,520.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $14,870.76 / $21,795.49
| Facility | | $6,600.00 | $14,870.76 | $21,795.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,047.69 / $13,476.22 / $22,575.82
| Facility | | $10,047.69 | $13,476.22 | $22,575.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,777.11 / $11,274.40 / $13,952.06
| Facility | | $7,777.11 | $11,274.40 | $13,952.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,387.27 / $13,088.74 / $20,397.54
| Facility | | $6,387.27 | $13,088.74 | $20,397.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,306.69 / $14,436.94 / $19,627.81
| Facility | | $10,306.69 | $14,436.94 | $19,627.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,855.85 / $28,279.77
| Facility | | $3,775.00 | $10,855.85 | $28,279.77 |