- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,065.40 / $20,839.00 / $36,697.50
| Facility | | $13,065.40 | $20,839.00 | $36,697.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $20,121.29 / $29,072.28
| Facility | | $6,600.00 | $20,121.29 | $29,072.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,081.07 / $16,203.44 / $27,144.54
| Facility | | $12,081.07 | $16,203.44 | $27,144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,435.68 / $14,526.40 / $18,937.24
| Facility | | $9,435.68 | $14,526.40 | $18,937.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $17,412.53 / $27,711.99
| Facility | | $6,409.00 | $17,412.53 | $27,711.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,265.25 / $19,718.96 / $26,812.27
| Facility | | $14,265.25 | $19,718.96 | $26,812.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,052.77 / $34,002.82
| Facility | | $3,775.00 | $13,052.77 | $34,002.82 |