- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,202.50 / $21,338.50 / $25,765.80
| Facility | | $11,202.50 | $21,338.50 | $25,765.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $19,268.30 / $33,074.26
| Facility | | $6,916.00 | $19,268.30 | $33,074.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,233.40 / $18,241.90 / $21,725.58
| Facility | | $15,233.40 | $18,241.90 | $21,725.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,753.46 / $14,949.80 / $20,247.18
| Facility | | $9,753.46 | $14,949.80 | $20,247.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,567.47 / $19,271.68 / $29,877.79
| Facility | | $11,567.47 | $19,271.68 | $29,877.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,772.01 / $17,394.40 / $21,695.89
| Facility | | $12,772.01 | $17,394.40 | $21,695.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,569.09 / $25,308.69
| Facility | | $3,775.00 | $17,569.09 | $25,308.69 |