- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,848.00 / $20,492.20 / $36,086.80
| Facility | | $12,848.00 | $20,492.20 | $36,086.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $16,791.14 / $24,442.54
| Facility | | $6,746.00 | $16,791.14 | $24,442.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,880.03 / $15,933.80 / $26,692.83
| Facility | | $11,880.03 | $15,933.80 | $26,692.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,069.48 / $13,473.90 / $16,270.55
| Facility | | $9,069.48 | $13,473.90 | $16,270.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $14,851.04 / $22,874.81
| Facility | | $6,409.00 | $14,851.04 | $22,874.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,558.43 / $16,190.30 / $22,011.59
| Facility | | $11,558.43 | $16,190.30 | $22,011.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,835.56 / $33,436.98
| Facility | | $3,775.00 | $12,835.56 | $33,436.98 |