- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,109.10 / $15,607.00 / $31,717.50
| Facility | | $12,109.10 | $15,607.00 | $31,717.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,178.09 / $17,347.91 / $19,333.20
| Facility | | $9,178.09 | $17,347.91 | $19,333.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,961.69 / $13,740.71 / $15,709.18
| Facility | | $10,961.69 | $13,740.71 | $15,709.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,665.66 / $17,109.23 / $22,251.29
| Facility | | $9,665.66 | $17,109.23 | $22,251.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,950.11 / $19,950.11 / $22,122.01
| Facility | | $19,950.11 | $19,950.11 | $22,122.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $17,751.34 / $24,064.44
| Facility | | $2,000.00 | $17,751.34 | $24,064.44 |