- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,746.30 / $26,183.90 / $31,616.40
| Facility | | $13,746.30 | $26,183.90 | $31,616.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $23,643.55 / $39,275.71
| Facility | | $12,397.00 | $23,643.55 | $39,275.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,055.00 / $21,942.54 / $25,739.52
| Facility | | $17,055.00 | $21,942.54 | $25,739.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,335.79 / $18,020.00 / $23,611.42
| Facility | | $11,335.79 | $18,020.00 | $23,611.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,461.37 / $23,643.55 / $37,579.33
| Facility | | $13,461.37 | $23,643.55 | $37,579.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,894.18 / $21,541.24 / $30,750.71
| Facility | | $14,894.18 | $21,541.24 | $30,750.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $23,101.40 / $33,238.43
| Facility | | $3,775.00 | $23,101.40 | $33,238.43 |