- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,523.19 / $19,316.80 / $32,037.50
| Facility | | $13,523.19 | $19,316.80 | $32,037.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,988.00 / $12,714.07 / $17,301.00
| Facility | | $2,988.00 | $12,714.07 | $17,301.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,690.65 / $17,513.29 / $29,667.88
| Facility | | $11,690.65 | $17,513.29 | $29,667.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,633.34 / $20,582.39 / $29,594.97
| Facility | | $16,633.34 | $20,582.39 | $29,594.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,340.00 / $20,663.46 / $33,124.40
| Facility | | $10,340.00 | $20,663.46 | $33,124.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,944.60 / $19,728.72 / $27,727.74
| Facility | | $9,944.60 | $19,728.72 | $27,727.74 |