- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,899.20 / $20,574.00 / $36,230.80
| Facility | | $12,899.20 | $20,574.00 | $36,230.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,136.82 / $17,195.49 / $25,140.90
| Facility | | $7,136.82 | $17,195.49 | $25,140.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,927.42 / $15,997.36 / $26,799.31
| Facility | | $11,927.42 | $15,997.36 | $26,799.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,923.96 / $13,343.55 / $16,009.51
| Facility | | $8,923.96 | $13,343.55 | $16,009.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,210.58 / $23,528.38
| Facility | | $6,409.00 | $15,210.58 | $23,528.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,888.67 / $16,652.88 / $22,640.50
| Facility | | $11,888.67 | $16,652.88 | $22,640.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,827.53 / $18,153.59 / $25,457.06
| Facility | | $6,827.53 | $18,153.59 | $25,457.06 |