- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,918.30 / $25,389.30 / $44,710.50
| Facility | | $15,918.30 | $25,389.30 | $44,710.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,488.36 / $21,960.78 / $32,138.74
| Facility | | $7,488.36 | $21,960.78 | $32,138.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,719.00 / $19,741.50 / $33,071.62
| Facility | | $14,719.00 | $19,741.50 | $33,071.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,483.50 / $16,963.65 / $20,601.27
| Facility | | $11,483.50 | $16,963.65 | $20,601.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $19,253.07 / $30,300.92
| Facility | | $6,600.00 | $19,253.07 | $30,300.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,310.78 / $21,446.34 / $29,157.47
| Facility | | $15,310.78 | $21,446.34 | $29,157.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,902.88 / $41,427.43
| Facility | | $3,775.00 | $15,902.88 | $41,427.43 |