- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,217.50 / $25,176.70 / $30,400.30
| Facility | | $13,217.50 | $25,176.70 | $30,400.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $22,734.10 / $34,505.78
| Facility | | $12,397.00 | $22,734.10 | $34,505.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,529.60 / $20,973.06 / $24,537.36
| Facility | | $14,529.60 | $20,973.06 | $24,537.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,100.62 / $15,789.60 / $20,743.88
| Facility | | $10,100.62 | $15,789.60 | $20,743.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,833.00 / $20,200.20 / $31,616.26
| Facility | | $12,833.00 | $20,200.20 | $31,616.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,085.32 / $18,241.29 / $23,731.74
| Facility | | $13,085.32 | $18,241.29 | $23,731.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $22,212.80 / $31,959.92
| Facility | | $3,775.00 | $22,212.80 | $31,959.92 |