- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,228.30 / $19,503.90 / $34,346.40
| Facility | | $12,228.30 | $19,503.90 | $34,346.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,060.31 / $17,997.03 / $26,162.52
| Facility | | $8,060.31 | $17,997.03 | $26,162.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,307.06 / $15,165.32 / $25,405.46
| Facility | | $11,307.06 | $15,165.32 | $25,405.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,697.16 / $14,350.95 / $19,427.64
| Facility | | $10,697.16 | $14,350.95 | $19,427.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $16,202.17 / $24,484.47
| Facility | | $6,600.00 | $16,202.17 | $24,484.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,371.78 / $17,476.95 / $23,737.79
| Facility | | $12,371.78 | $17,476.95 | $23,737.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,216.51 / $31,824.35
| Facility | | $3,775.00 | $12,216.51 | $31,824.35 |