- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,746.30 / $20,469.50 / $24,716.40
| Facility | | $10,746.30 | $20,469.50 | $24,716.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $18,483.55 / $33,560.00
| Facility | | $12,397.00 | $18,483.55 | $33,560.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,486.84 / $17,651.68 / $20,600.18
| Facility | | $15,486.84 | $17,651.68 | $20,600.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,564.64 / $15,964.70 / $21,086.04
| Facility | | $10,564.64 | $15,964.70 | $21,086.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,637.59 / $20,474.12 / $30,164.80
| Facility | | $12,637.59 | $20,474.12 | $30,164.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,301.16 / $17,795.38 / $24,236.99
| Facility | | $13,301.16 | $17,795.38 | $24,236.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,059.72 / $25,984.43
| Facility | | $3,775.00 | $18,059.72 | $25,984.43 |