- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,888.80 / $24,550.50 / $29,644.10
| Facility | | $12,888.80 | $24,550.50 | $29,644.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $22,168.65 / $38,052.75
| Facility | | $6,916.00 | $22,168.65 | $38,052.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,155.09 / $20,662.22 / $25,102.34
| Facility | | $18,155.09 | $20,662.22 | $25,102.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,138.85 / $18,122.00 / $23,452.00
| Facility | | $12,138.85 | $18,122.00 | $23,452.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,217.81 / $22,754.06 / $34,207.01
| Facility | | $13,217.81 | $22,754.06 | $34,207.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,622.64 / $20,532.61 / $26,146.52
| Facility | | $14,622.64 | $20,532.61 | $26,146.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,213.68 / $29,118.26
| Facility | | $3,775.00 | $20,213.68 | $29,118.26 |