- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,516.30 / $20,031.40 / $24,187.40
| Facility | | $10,516.30 | $20,031.40 | $24,187.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $18,087.95 / $32,843.26
| Facility | | $6,916.00 | $18,087.95 | $32,843.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,591.61 / $17,273.91 / $20,734.12
| Facility | | $14,591.61 | $17,273.91 | $20,734.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,435.68 / $16,511.37 / $23,298.00
| Facility | | $9,435.68 | $16,511.37 | $23,298.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,302.50 / $20,347.50 / $31,048.18
| Facility | | $11,302.50 | $20,347.50 | $31,048.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,017.09 / $18,041.64 / $25,227.67
| Facility | | $13,017.09 | $18,041.64 | $25,227.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,673.18 / $23,758.31
| Facility | | $3,775.00 | $17,673.18 | $23,758.31 |