- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,718.90 / $18,691.40 / $32,915.69
| Facility | | $11,718.90 | $18,691.40 | $32,915.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $15,969.37 / $23,405.68
| Facility | | $6,746.00 | $15,969.37 | $23,405.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,836.06 / $14,533.60 / $24,347.17
| Facility | | $10,836.06 | $14,533.60 | $24,347.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,888.45 / $12,957.41 / $15,945.79
| Facility | | $8,888.45 | $12,957.41 | $15,945.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $14,077.94 / $21,904.45
| Facility | | $6,409.00 | $14,077.94 | $21,904.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,068.12 / $15,503.50 / $21,077.85
| Facility | | $11,068.12 | $15,503.50 | $21,077.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,707.62 / $30,498.67
| Facility | | $3,775.00 | $11,707.62 | $30,498.67 |