- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,942.50 / $24,652.90 / $29,767.80
| Facility | | $12,942.50 | $24,652.90 | $29,767.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $22,261.10 / $37,696.75
| Facility | | $12,397.00 | $22,261.10 | $37,696.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,442.20 / $20,932.37 / $24,712.32
| Facility | | $18,442.20 | $20,932.37 | $24,712.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,072.50 / $18,132.84 / $29,885.52
| Facility | | $13,072.50 | $18,132.84 | $29,885.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,927.01 / $22,959.27 / $34,923.96
| Facility | | $12,927.01 | $22,959.27 | $34,923.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,295.41 / $20,073.11 / $27,039.12
| Facility | | $14,295.41 | $20,073.11 | $27,039.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,750.65 / $31,294.97
| Facility | | $3,775.00 | $21,750.65 | $31,294.97 |