- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,842.50 / $18,748.00 / $22,637.80
| Facility | | $9,842.50 | $18,748.00 | $22,637.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,929.09 / $30,738.74
| Facility | | $6,916.00 | $16,929.09 | $30,738.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,270.68 / $16,182.32 / $19,860.09
| Facility | | $14,270.68 | $16,182.32 | $19,860.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,697.16 / $14,632.70 / $19,427.64
| Facility | | $10,697.16 | $14,632.70 | $19,427.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,040.56 / $18,555.18 / $28,499.87
| Facility | | $11,040.56 | $18,555.18 | $28,499.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,182.98 / $16,591.79 / $20,519.53
| Facility | | $12,182.98 | $16,591.79 | $20,519.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,436.19 / $22,236.18
| Facility | | $3,775.00 | $15,436.19 | $22,236.18 |