- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,497.40 / $24,718.00 / $43,528.40
| Facility | | $15,497.40 | $24,718.00 | $43,528.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,381.16 / $21,057.89 / $30,663.73
| Facility | | $8,381.16 | $21,057.89 | $30,663.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,329.84 / $19,219.55 / $32,197.24
| Facility | | $14,329.84 | $19,219.55 | $32,197.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,538.50 / $16,820.58 / $20,699.93
| Facility | | $11,538.50 | $16,820.58 | $20,699.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $18,627.14 / $28,696.97
| Facility | | $6,600.00 | $18,627.14 | $28,696.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,500.32 / $20,311.09 / $27,614.05
| Facility | | $14,500.32 | $20,311.09 | $27,614.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,202.74 / $21,810.10 / $30,584.64
| Facility | | $8,202.74 | $21,810.10 | $30,584.64 |