- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,436.20 / $16,645.40 / $29,312.60
| Facility | | $10,436.20 | $16,645.40 | $29,312.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,684.00 / $12,897.23 / $18,874.59
| Facility | | $5,684.00 | $12,897.23 | $18,874.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,649.92 / $12,942.72 / $21,682.08
| Facility | | $9,649.92 | $12,942.72 | $21,682.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,313.10 / $9,955.75 / $13,119.62
| Facility | | $7,313.10 | $9,955.75 | $13,119.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,555.24 / $11,305.94 / $17,740.46
| Facility | | $5,555.24 | $11,305.94 | $17,740.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,964.09 / $12,556.32 / $17,071.00
| Facility | | $8,964.09 | $12,556.32 | $17,071.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,426.08 / $27,160.22
| Facility | | $3,775.00 | $10,426.08 | $27,160.22 |