- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,206.40 / $17,874.00 / $31,476.20
| Facility | | $11,206.40 | $17,874.00 | $31,476.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,188.00 / $15,883.00 / $22,496.90
| Facility | | $7,188.00 | $15,883.00 | $22,496.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,362.18 / $13,898.02 / $23,282.42
| Facility | | $10,362.18 | $13,898.02 | $23,282.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,198.37 / $13,201.33 / $17,122.59
| Facility | | $9,198.37 | $13,201.33 | $17,122.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $13,935.65 / $21,195.60
| Facility | | $6,746.00 | $13,935.65 | $21,195.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,985.83 / $15,053.51 / $20,482.98
| Facility | | $10,985.83 | $15,053.51 | $20,482.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,195.62 / $29,164.91
| Facility | | $3,775.00 | $11,195.62 | $29,164.91 |