- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,886.30 / $20,736.09 / $25,038.40
| Facility | | $10,886.30 | $20,736.09 | $25,038.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $18,724.34 / $32,140.56
| Facility | | $6,916.00 | $18,724.34 | $32,140.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,296.67 / $17,881.66 / $22,251.62
| Facility | | $15,296.67 | $17,881.66 | $22,251.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,742.01 / $14,511.20 / $19,443.66
| Facility | | $9,742.01 | $14,511.20 | $19,443.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,116.36 / $18,755.64 / $28,692.06
| Facility | | $11,116.36 | $18,755.64 | $28,692.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,265.14 / $16,999.43 / $21,839.54
| Facility | | $12,265.14 | $16,999.43 | $21,839.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,073.12 / $24,594.22
| Facility | | $3,775.00 | $17,073.12 | $24,594.22 |