- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,237.50 / $23,310.00 / $28,146.30
| Facility | | $12,237.50 | $23,310.00 | $28,146.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,048.50 / $36,130.00
| Facility | | $6,916.00 | $21,048.50 | $36,130.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,493.54 / $19,755.80 / $23,867.22
| Facility | | $17,493.54 | $19,755.80 | $23,867.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,493.81 / $16,484.90 / $22,501.05
| Facility | | $11,493.81 | $16,484.90 | $22,501.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,836.28 / $21,617.64 / $33,203.69
| Facility | | $12,836.28 | $21,617.64 | $33,203.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,193.75 / $19,196.88 / $23,664.87
| Facility | | $14,193.75 | $19,196.88 | $23,664.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,192.32 / $27,646.96
| Facility | | $3,775.00 | $19,192.32 | $27,646.96 |