- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,186.30 / $17,841.80 / $31,419.50
| Facility | | $11,186.30 | $17,841.80 | $31,419.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $14,455.38 / $20,883.65
| Facility | | $6,600.00 | $14,455.38 | $20,883.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,343.51 / $13,872.98 / $23,240.48
| Facility | | $10,343.51 | $13,872.98 | $23,240.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,750.76 / $11,896.50 / $14,079.81
| Facility | | $7,750.76 | $11,896.50 | $14,079.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,337.23 / $12,509.37 / $19,908.63
| Facility | | $6,337.23 | $12,509.37 | $19,908.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,225.93 / $14,141.79 / $19,220.16
| Facility | | $10,225.93 | $14,141.79 | $19,220.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,175.45 / $29,112.37
| Facility | | $3,775.00 | $11,175.45 | $29,112.37 |