- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,675.00 / $24,143.30 / $29,152.50
| Facility | | $12,675.00 | $24,143.30 | $29,152.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,801.00 / $37,311.19
| Facility | | $6,916.00 | $21,801.00 | $37,311.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,480.36 / $20,341.28 / $24,155.76
| Facility | | $17,480.36 | $20,341.28 | $24,155.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,477.77 / $16,887.80 / $22,430.41
| Facility | | $11,477.77 | $16,887.80 | $22,430.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,796.52 / $21,801.00 / $33,305.69
| Facility | | $12,796.52 | $21,801.00 | $33,305.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,149.19 / $19,227.83 / $25,537.25
| Facility | | $14,149.19 | $19,227.83 | $25,537.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,878.46 / $28,635.36
| Facility | | $3,775.00 | $19,878.46 | $28,635.36 |