- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,121.25 / $17,374.20 / $20,978.90
| Facility | | $9,121.25 | $17,374.20 | $20,978.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $15,688.55 / $26,423.71
| Facility | | $6,916.00 | $15,688.55 | $26,423.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,763.80 / $14,978.00 / $18,718.70
| Facility | | $12,763.80 | $14,978.00 | $18,718.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,612.34 / $12,384.50 / $16,210.94
| Facility | | $8,612.34 | $12,384.50 | $16,210.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,110.60 / $15,651.30 / $23,440.97
| Facility | | $9,110.60 | $15,651.30 | $23,440.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,020.43 / $13,406.15 / $18,347.39
| Facility | | $10,020.43 | $13,406.15 | $18,347.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,328.81 / $20,606.73
| Facility | | $3,775.00 | $15,328.81 | $20,606.73 |