- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,472.50 / $25,662.40 / $30,986.80
| Facility | | $13,472.50 | $25,662.40 | $30,986.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $23,172.70 / $36,786.10
| Facility | | $6,916.00 | $23,172.70 | $36,786.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,950.59 / $21,401.34 / $25,334.78
| Facility | | $16,950.59 | $21,401.34 | $25,334.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,797.43 / $16,988.09 / $22,114.74
| Facility | | $11,797.43 | $16,988.09 | $22,114.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,618.80 / $21,789.15 / $34,172.17
| Facility | | $12,618.80 | $21,789.15 | $34,172.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,950.07 / $19,588.20 / $24,578.77
| Facility | | $13,950.07 | $19,588.20 | $24,578.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,129.19 / $30,437.07
| Facility | | $3,775.00 | $21,129.19 | $30,437.07 |