- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,259.60 / $22,743.80 / $40,051.90
| Facility | | $14,259.60 | $22,743.80 | $40,051.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $18,894.88 / $27,467.75
| Facility | | $6,746.00 | $18,894.88 | $27,467.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,185.35 / $17,684.53 / $29,625.72
| Facility | | $13,185.35 | $17,684.53 | $29,625.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,115.52 / $14,746.20 / $18,147.13
| Facility | | $10,115.52 | $14,746.20 | $18,147.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $17,093.03 / $25,705.98
| Facility | | $6,409.00 | $17,093.03 | $25,705.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,988.99 / $18,379.68 / $25,008.84
| Facility | | $12,988.99 | $18,379.68 | $25,008.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,245.87 / $37,110.89
| Facility | | $3,775.00 | $14,245.87 | $37,110.89 |