- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,366.25 / $17,840.80 / $21,542.40
| Facility | | $9,366.25 | $17,840.80 | $21,542.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,109.95 / $27,470.23
| Facility | | $6,916.00 | $16,109.95 | $27,470.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,886.20 / $15,316.96 / $19,072.64
| Facility | | $12,886.20 | $15,316.96 | $19,072.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,901.06 / $12,782.30 / $16,541.80
| Facility | | $8,901.06 | $12,782.30 | $16,541.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,464.78 / $15,947.10 / $24,369.36
| Facility | | $9,464.78 | $15,947.10 | $24,369.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,417.29 / $14,438.33 / $18,394.45
| Facility | | $10,417.29 | $14,438.33 | $18,394.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,689.28 / $21,160.23
| Facility | | $3,775.00 | $14,689.28 | $21,160.23 |