- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,006.30 / $22,869.50 / $27,614.40
| Facility | | $12,006.30 | $22,869.50 | $27,614.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $20,650.75 / $35,067.60
| Facility | | $6,916.00 | $20,650.75 | $35,067.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,848.30 / $19,360.58 / $23,167.06
| Facility | | $12,848.30 | $19,360.58 | $23,167.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,955.65 / $15,108.20 / $21,081.63
| Facility | | $8,955.65 | $15,108.20 | $21,081.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,872.58 / $20,724.59 / $32,296.32
| Facility | | $10,872.58 | $20,724.59 | $32,296.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,298.38 / $18,431.50 / $24,687.75
| Facility | | $13,298.38 | $18,431.50 | $24,687.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,829.64 / $27,124.52
| Facility | | $3,775.00 | $18,829.64 | $27,124.52 |