- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,078.00 / $11,227.00 / $19,089.50
| Facility | | $5,078.00 | $11,227.00 | $19,089.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,745.94 / $17,430.16 / $22,601.56
| Facility | | $11,745.94 | $17,430.16 | $22,601.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,116.16 / $17,084.81 / $24,494.40
| Facility | | $12,116.16 | $17,084.81 | $24,494.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,588.83 / $16,503.65 / $34,608.67
| Facility | | $8,588.83 | $16,503.65 | $34,608.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,116.16 / $17,648.00 / $24,500.45
| Facility | | $12,116.16 | $17,648.00 | $24,500.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,851.17 / $14,238.00 / $21,575.23
| Facility | | $4,851.17 | $14,238.00 | $21,575.23 |