- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,332.20 / $18,074.70 / $31,829.50
| Facility | | $11,332.20 | $18,074.70 | $31,829.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $14,489.50 / $21,331.74
| Facility | | $6,600.00 | $14,489.50 | $21,331.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,478.49 / $14,054.02 / $23,543.77
| Facility | | $10,478.49 | $14,054.02 | $23,543.77 |
- 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
- $6,172.79 / $13,303.56 / $19,712.58
| Facility | | $6,172.79 | $13,303.56 | $19,712.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,960.58 / $14,204.90 / $19,318.66
| Facility | | $9,960.58 | $14,204.90 | $19,318.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,321.30 / $29,492.28
| Facility | | $3,775.00 | $11,321.30 | $29,492.28 |