- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,382.80 / $15,959.80 / $32,434.60
| Facility | | $12,382.80 | $15,959.80 | $32,434.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,617.33 / $13,829.36 / $18,508.25
| Facility | | $10,617.33 | $13,829.36 | $18,508.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,400.86 / $15,544.74 / $17,771.66
| Facility | | $12,400.86 | $15,544.74 | $17,771.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,884.16 / $17,496.00 / $22,754.30
| Facility | | $9,884.16 | $17,496.00 | $22,754.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,209.93 / $15,903.76 / $21,284.50
| Facility | | $12,209.93 | $15,903.76 | $21,284.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $15,897.60 / $22,349.95
| Facility | | $1,518.00 | $15,897.60 | $22,349.95 |