- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,477.50 / $21,862.30 / $26,398.30
| Facility | | $11,477.50 | $21,862.30 | $26,398.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $19,741.30 / $33,886.17
| Facility | | $6,916.00 | $19,741.30 | $33,886.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,429.60 / $18,624.66 / $22,206.46
| Facility | | $15,429.60 | $18,624.66 | $22,206.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,115.52 / $14,965.10 / $20,373.02
| Facility | | $10,115.52 | $14,965.10 | $20,373.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,638.30 / $19,421.77 / $30,063.47
| Facility | | $11,638.30 | $19,421.77 | $30,063.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,851.38 / $17,419.54 / $22,240.77
| Facility | | $12,851.38 | $17,419.54 | $22,240.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,000.39 / $25,929.97
| Facility | | $3,775.00 | $18,000.39 | $25,929.97 |