- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,382.50 / $19,776.59 / $23,879.80
| Facility | | $10,382.50 | $19,776.59 | $23,879.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $17,857.90 / $29,981.88
| Facility | | $6,916.00 | $17,857.90 | $29,981.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,392.00 / $16,722.88 / $20,540.86
| Facility | | $13,392.00 | $16,722.88 | $20,540.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,923.96 / $13,747.90 / $18,024.24
| Facility | | $8,923.96 | $13,747.90 | $18,024.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,316.04 / $17,477.28 / $26,597.49
| Facility | | $10,316.04 | $17,477.28 | $26,597.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,369.76 / $15,787.26 / $20,011.74
| Facility | | $11,369.76 | $15,787.26 | $20,011.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,740.00 / $18,459.25 / $22,509.26
| Facility | | $10,740.00 | $18,459.25 | $22,509.26 |