- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,139.80 / $19,362.70 / $34,097.80
| Facility | | $12,139.80 | $19,362.70 | $34,097.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $16,419.48 / $23,869.22
| Facility | | $6,746.00 | $16,419.48 | $23,869.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,225.21 / $15,055.54 / $25,221.55
| Facility | | $11,225.21 | $15,055.54 | $25,221.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,329.56 / $13,110.40 / $16,737.12
| Facility | | $9,329.56 | $13,110.40 | $16,737.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $14,556.70 / $22,338.26
| Facility | | $6,409.00 | $14,556.70 | $22,338.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,287.32 / $15,810.54 / $21,495.29
| Facility | | $11,287.32 | $15,810.54 | $21,495.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,425.57 / $17,084.84 / $23,958.32
| Facility | | $6,425.57 | $17,084.84 | $23,958.32 |