- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,165.00 / $21,267.10 / $25,679.50
| Facility | | $11,165.00 | $21,267.10 | $25,679.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $19,203.80 / $31,718.74
| Facility | | $6,916.00 | $19,203.80 | $31,718.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,222.60 / $18,011.91 / $21,833.18
| Facility | | $15,222.60 | $18,011.91 | $21,833.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,815.34 / $14,643.80 / $19,068.39
| Facility | | $9,815.34 | $14,643.80 | $19,068.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,903.85 / $18,744.46 / $28,155.60
| Facility | | $10,903.85 | $18,744.46 | $28,155.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,028.42 / $16,821.36 / $21,522.52
| Facility | | $12,028.42 | $16,821.36 | $21,522.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,510.29 / $25,223.97
| Facility | | $3,775.00 | $17,510.29 | $25,223.97 |