- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,687.50 / $24,167.20 / $29,181.30
| Facility | | $12,687.50 | $24,167.20 | $29,181.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,822.50 / $37,450.73
| Facility | | $6,916.00 | $21,822.50 | $37,450.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,073.93 / $20,382.12 / $24,720.64
| Facility | | $18,073.93 | $20,382.12 | $24,720.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,991.05 / $17,459.00 / $22,594.00
| Facility | | $11,991.05 | $17,459.00 | $22,594.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,842.50 / $21,756.74 / $33,223.24
| Facility | | $12,842.50 | $21,756.74 | $33,223.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,202.11 / $19,684.07 / $25,066.68
| Facility | | $14,202.11 | $19,684.07 | $25,066.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,124.00 / $22,557.36 / $27,506.50
| Facility | | $13,124.00 | $22,557.36 | $27,506.50 |