- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,891.50 / $20,561.59 / $36,209.00
| Facility | | $12,891.50 | $20,561.59 | $36,209.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,944.31 / $17,239.72 / $25,061.61
| Facility | | $6,944.31 | $17,239.72 | $25,061.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,920.24 / $15,987.73 / $26,783.18
| Facility | | $11,920.24 | $15,987.73 | $26,783.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,612.34 / $13,076.25 / $15,732.54
| Facility | | $8,612.34 | $13,076.25 | $15,732.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,514.76 / $23,454.17
| Facility | | $6,409.00 | $15,514.76 | $23,454.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,851.18 / $16,671.91 / $22,644.37
| Facility | | $11,851.18 | $16,671.91 | $22,644.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,879.00 / $33,550.15
| Facility | | $3,775.00 | $12,879.00 | $33,550.15 |