- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,947.50 / $20,852.80 / $25,179.30
| Facility | | $10,947.50 | $20,852.80 | $25,179.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $18,829.70 / $32,321.40
| Facility | | $6,916.00 | $18,829.70 | $32,321.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,757.62 / $17,960.34 / $21,456.52
| Facility | | $15,757.62 | $17,960.34 | $21,456.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,647.13 / $14,948.10 / $19,622.47
| Facility | | $10,647.13 | $14,948.10 | $19,622.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,215.79 / $19,209.18 / $28,994.76
| Facility | | $11,215.79 | $19,209.18 | $28,994.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,377.93 / $17,250.32 / $22,163.99
| Facility | | $12,377.93 | $17,250.32 | $22,163.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,169.18 / $24,732.59
| Facility | | $3,775.00 | $17,169.18 | $24,732.59 |