- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,016.30 / $22,888.60 / $27,637.40
| Facility | | $12,016.30 | $22,888.60 | $27,637.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $20,667.95 / $35,390.74
| Facility | | $6,916.00 | $20,667.95 | $35,390.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,566.40 / $19,374.48 / $23,181.82
| Facility | | $15,566.40 | $19,374.48 | $23,181.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,240.40 / $16,037.80 / $21,275.89
| Facility | | $10,240.40 | $16,037.80 | $21,275.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,146.58 / $20,458.65 / $31,395.79
| Facility | | $12,146.58 | $20,458.65 | $31,395.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,420.92 / $18,601.34 / $23,788.70
| Facility | | $13,420.92 | $18,601.34 | $23,788.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,845.33 / $27,147.11
| Facility | | $3,775.00 | $18,845.33 | $27,147.11 |