- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,426.07 / $13,365.00 / $22,941.50
| Facility | | $6,426.07 | $13,365.00 | $22,941.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,694.15 / $23,289.04 / $30,198.72
| Facility | | $15,694.15 | $23,289.04 | $30,198.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,561.03 / $18,410.86 / $29,437.02
| Facility | | $14,561.03 | $18,410.86 | $29,437.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,321.94 / $19,833.84 / $41,592.21
| Facility | | $10,321.94 | $19,833.84 | $41,592.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,661.83 / $7,661.83 / $7,844.85
| Facility | | $7,661.83 | $7,661.83 | $7,844.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,561.03 / $19,702.87 / $29,444.29
| Facility | | $14,561.03 | $19,702.87 | $29,444.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $15,902.00 / $25,323.91
| Facility | | $4,870.00 | $15,902.00 | $25,323.91 |