- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,806.86 / $24,387.20 / $33,486.00
| Facility | | $9,806.86 | $24,387.20 | $33,486.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,884.00 / $15,768.00 / $19,111.37
| Facility | | $7,884.00 | $15,768.00 | $19,111.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,258.95 / $9,238.83 / $15,320.26
| Facility | | $6,258.95 | $9,238.83 | $15,320.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,820.60 / $15,088.69 / $20,834.78
| Facility | | $8,820.60 | $15,088.69 | $20,834.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,012.95 / $31,012.95 / $36,396.33
| Facility | | $31,012.95 | $31,012.95 | $36,396.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $14,265.89 / $20,377.18
| Facility | | $1,787.00 | $14,265.89 | $20,377.18 |