- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,623.75 / $16,426.50 / $19,834.59
| Facility | | $8,623.75 | $16,426.50 | $19,834.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,832.85 / $25,460.76
| Facility | | $6,916.00 | $14,832.85 | $25,460.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,630.66 / $14,165.30 / $17,999.96
| Facility | | $12,630.66 | $14,165.30 | $17,999.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,831.79 / $12,317.25 / $16,423.00
| Facility | | $8,831.79 | $12,317.25 | $16,423.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,794.96 / $15,534.97 / $23,728.05
| Facility | | $8,794.96 | $15,534.97 | $23,728.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,666.74 / $13,563.95 / $18,347.39
| Facility | | $9,666.74 | $13,563.95 | $18,347.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,524.80 / $19,482.78
| Facility | | $3,775.00 | $13,524.80 | $19,482.78 |