- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,820.30 / $23,638.00 / $41,626.60
| Facility | | $14,820.30 | $23,638.00 | $41,626.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,008.48 / $19,732.59 / $28,580.90
| Facility | | $7,008.48 | $19,732.59 | $28,580.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,703.75 / $18,379.82 / $30,790.49
| Facility | | $13,703.75 | $18,379.82 | $30,790.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,088.23 / $15,901.80 / $19,892.16
| Facility | | $11,088.23 | $15,901.80 | $19,892.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $17,118.18 / $27,243.55
| Facility | | $6,409.00 | $17,118.18 | $27,243.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,945.11 / $19,354.14 / $26,246.64
| Facility | | $13,945.11 | $19,354.14 | $26,246.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,844.35 / $20,857.18 / $29,248.34
| Facility | | $7,844.35 | $20,857.18 | $29,248.34 |