- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,216.30 / $23,269.50 / $28,097.40
| Facility | | $12,216.30 | $23,269.50 | $28,097.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $21,011.95 / $35,093.30
| Facility | | $12,397.00 | $21,011.95 | $35,093.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,572.59 / $19,571.88 / $23,477.54
| Facility | | $16,572.59 | $19,571.88 | $23,477.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,271.54 / $16,460.46 / $21,527.00
| Facility | | $11,271.54 | $16,460.46 | $21,527.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,833.00 / $20,737.50 / $31,995.00
| Facility | | $12,833.00 | $20,737.50 | $31,995.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,308.12 / $18,445.00 / $24,457.41
| Facility | | $13,308.12 | $18,445.00 | $24,457.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,530.14 / $29,538.89
| Facility | | $3,775.00 | $20,530.14 | $29,538.89 |