- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,690.20 / $15,318.30 / $22,809.76
| Facility | | $9,690.20 | $15,318.30 | $22,809.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,158.60 / $13,644.92 / $31,410.55
| Facility | | $11,158.60 | $13,644.92 | $31,410.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,684.00 / $11,506.55 / $20,658.93
| Facility | | $1,684.00 | $11,506.55 | $20,658.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,300.67 / $16,078.00 / $28,204.03
| Facility | | $10,300.67 | $16,078.00 | $28,204.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,921.20 / $21,666.40 / $25,427.36
| Facility | | $14,921.20 | $21,666.40 | $25,427.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,918.94 / $13,600.38 / $28,450.02
| Facility | | $9,918.94 | $13,600.38 | $28,450.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,017.00 / $13,588.32 / $27,631.65
| Facility | | $5,017.00 | $13,588.32 | $27,631.65 |