- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,778.80 / $24,341.00 / $29,391.10
| Facility | | $12,778.80 | $24,341.00 | $29,391.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $21,979.45 / $37,439.71
| Facility | | $12,397.00 | $21,979.45 | $37,439.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,299.00 / $20,496.34 / $24,309.16
| Facility | | $16,299.00 | $20,496.34 | $24,309.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,673.69 / $17,017.66 / $22,507.67
| Facility | | $11,673.69 | $17,017.66 | $22,507.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,840.02 / $21,930.52 / $33,459.48
| Facility | | $12,840.02 | $21,930.52 | $33,459.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,197.93 / $19,936.24 / $25,576.88
| Facility | | $14,197.93 | $19,936.24 | $25,576.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,475.46 / $30,899.02
| Facility | | $3,775.00 | $21,475.46 | $30,899.02 |