- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,452.50 / $19,909.90 / $24,040.80
| Facility | | $10,452.50 | $19,909.90 | $24,040.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $17,978.30 / $27,400.46
| Facility | | $6,916.00 | $17,978.30 | $27,400.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,187.60 / $17,019.12 / $20,642.00
| Facility | | $14,187.60 | $17,019.12 | $20,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,341.01 / $13,754.40 / $18,339.20
| Facility | | $9,341.01 | $13,754.40 | $18,339.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,442.43 / $17,453.96 / $26,767.05
| Facility | | $9,442.43 | $17,453.96 | $26,767.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,390.84 / $14,923.34 / $22,656.85
| Facility | | $10,390.84 | $14,923.34 | $22,656.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,566.05 / $23,614.29
| Facility | | $3,775.00 | $17,566.05 | $23,614.29 |