- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,068.80 / $21,083.80 / $25,458.10
| Facility | | $11,068.80 | $21,083.80 | $25,458.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $19,038.25 / $32,679.38
| Facility | | $6,916.00 | $19,038.25 | $32,679.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,170.60 / $18,055.72 / $21,532.30
| Facility | | $13,170.60 | $18,055.72 | $21,532.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,512.87 / $15,077.30 / $20,229.53
| Facility | | $9,512.87 | $15,077.30 | $20,229.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,556.28 / $19,243.24 / $29,851.73
| Facility | | $11,556.28 | $19,243.24 | $29,851.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,760.87 / $17,382.46 / $22,020.34
| Facility | | $12,760.87 | $17,382.46 | $22,020.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,601.70 / $25,006.52
| Facility | | $3,775.00 | $18,601.70 | $25,006.52 |