- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,697.00 / $18,390.00 / $29,588.70
| Facility | | $8,697.00 | $18,390.00 | $29,588.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,514.03 / $27,473.55 / $35,624.74
| Facility | | $18,514.03 | $27,473.55 | $35,624.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $23,745.36 / $37,966.32
| Facility | | $14,648.00 | $23,745.36 | $37,966.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,312.69 / $25,580.65 / $53,643.44
| Facility | | $13,312.69 | $25,580.65 | $53,643.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $25,411.73 / $37,975.69
| Facility | | $17,646.00 | $25,411.73 | $37,975.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,241.33 / $17,604.08 / $32,661.45
| Facility | | $5,241.33 | $17,604.08 | $32,661.45 |