- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,617.50 / $18,319.40 / $22,120.30
| Facility | | $9,617.50 | $18,319.40 | $22,120.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,542.09 / $30,036.06
| Facility | | $6,916.00 | $16,542.09 | $30,036.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,979.80 / $15,797.60 / $19,435.64
| Facility | | $12,979.80 | $15,797.60 | $19,435.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,389.14 / $11,749.50 / $18,871.91
| Facility | | $8,389.14 | $11,749.50 | $18,871.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,793.26 / $16,933.14 / $24,051.60
| Facility | | $10,793.26 | $16,933.14 | $24,051.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,287.57 / $13,935.72 / $18,515.81
| Facility | | $11,287.57 | $13,935.72 | $18,515.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,083.32 / $21,727.86
| Facility | | $3,775.00 | $15,083.32 | $21,727.86 |