- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,791.30 / $24,364.80 / $29,419.90
| Facility | | $12,791.30 | $24,364.80 | $29,419.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $22,000.95 / $37,764.89
| Facility | | $6,916.00 | $22,000.95 | $37,764.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,238.72 / $20,526.52 / $24,917.40
| Facility | | $18,238.72 | $20,526.52 | $24,917.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,083.86 / $17,447.09 / $22,759.33
| Facility | | $12,083.86 | $17,447.09 | $22,759.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,981.68 / $21,925.13 / $33,584.83
| Facility | | $12,981.68 | $21,925.13 | $33,584.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,356.68 / $19,898.30 / $25,460.48
| Facility | | $14,356.68 | $19,898.30 | $25,460.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,231.00 / $22,741.82 / $27,731.43
| Facility | | $13,231.00 | $22,741.82 | $27,731.43 |