- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,597.90 / $20,093.40 / $35,384.50
| Facility | | $12,597.90 | $20,093.40 | $35,384.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $16,784.50 / $24,399.85
| Facility | | $6,746.00 | $16,784.50 | $24,399.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,648.83 / $15,623.71 / $26,173.37
| Facility | | $11,648.83 | $15,623.71 | $26,173.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,298.62 / $13,555.34 / $16,681.63
| Facility | | $9,298.62 | $13,555.34 | $16,681.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,133.51 / $22,834.85
| Facility | | $6,409.00 | $15,133.51 | $22,834.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,538.24 / $16,322.34 / $22,169.56
| Facility | | $11,538.24 | $16,322.34 | $22,169.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,585.77 / $32,786.26
| Facility | | $3,775.00 | $12,585.77 | $32,786.26 |