- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,225.50 / $22,689.30 / $39,955.90
| Facility | | $14,225.50 | $22,689.30 | $39,955.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $19,064.81 / $27,714.76
| Facility | | $6,746.00 | $19,064.81 | $27,714.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,153.76 / $17,642.16 / $29,554.74
| Facility | | $13,153.76 | $17,642.16 | $29,554.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,691.60 / $14,914.35 / $17,398.07
| Facility | | $9,691.60 | $14,914.35 | $17,398.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $17,157.24 / $25,937.15
| Facility | | $6,409.00 | $17,157.24 | $25,937.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,105.80 / $18,451.78 / $25,061.83
| Facility | | $13,105.80 | $18,451.78 | $25,061.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,211.74 / $37,021.97
| Facility | | $3,775.00 | $14,211.74 | $37,021.97 |