- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,996.00 / $27,108.30 / $47,737.70
| Facility | | $16,996.00 | $27,108.30 | $47,737.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,437.89 / $22,798.89 / $33,143.05
| Facility | | $8,437.89 | $22,798.89 | $33,143.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,715.58 / $21,078.14 / $35,310.82
| Facility | | $15,715.58 | $21,078.14 | $35,310.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,122.81 / $17,778.75 / $21,748.19
| Facility | | $12,122.81 | $17,778.75 | $21,748.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $20,201.29 / $31,017.27
| Facility | | $6,600.00 | $20,201.29 | $31,017.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,672.74 / $21,953.36 / $29,846.79
| Facility | | $15,672.74 | $21,953.36 | $29,846.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,979.62 / $44,232.36
| Facility | | $3,775.00 | $16,979.62 | $44,232.36 |