- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,645.00 / $20,276.59 / $24,483.50
| Facility | | $10,645.00 | $20,276.59 | $24,483.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $18,309.40 / $30,727.30
| Facility | | $6,916.00 | $18,309.40 | $30,727.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,869.80 / $17,086.08 / $20,920.12
| Facility | | $14,869.80 | $17,086.08 | $20,920.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,336.64 / $14,431.30 / $18,675.80
| Facility | | $10,336.64 | $14,431.30 | $18,675.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,567.08 / $18,200.40 / $27,394.20
| Facility | | $10,567.08 | $18,200.40 | $27,394.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,652.44 / $16,361.95 / $20,940.50
| Facility | | $11,652.44 | $16,361.95 | $20,940.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,694.77 / $24,049.18
| Facility | | $3,775.00 | $16,694.77 | $24,049.18 |