- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,542.00 / $20,004.30 / $35,227.50
| Facility | | $12,542.00 | $20,004.30 | $35,227.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,862.47 / $16,511.78 / $24,041.56
| Facility | | $6,862.47 | $16,511.78 | $24,041.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,597.14 / $15,554.38 / $26,057.21
| Facility | | $11,597.14 | $15,554.38 | $26,057.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,644.42 / $12,733.05 / $15,507.99
| Facility | | $8,644.42 | $12,733.05 | $15,507.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,004.49 / $22,463.83
| Facility | | $6,409.00 | $15,004.49 | $22,463.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,350.77 / $16,061.56 / $21,854.62
| Facility | | $11,350.77 | $16,061.56 | $21,854.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,529.91 / $32,640.77
| Facility | | $3,775.00 | $12,529.91 | $32,640.77 |