- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,713.80 / $20,407.59 / $24,641.60
| Facility | | $10,713.80 | $20,407.59 | $24,641.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $18,427.65 / $31,631.28
| Facility | | $6,916.00 | $18,427.65 | $31,631.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,346.20 / $17,561.62 / $21,019.42
| Facility | | $12,346.20 | $17,561.62 | $21,019.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,595.15 / $13,457.20 / $19,527.55
| Facility | | $8,595.15 | $13,457.20 | $19,527.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,159.84 / $18,362.30 / $28,815.85
| Facility | | $11,159.84 | $18,362.30 | $28,815.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,318.06 / $16,486.24 / $20,251.98
| Facility | | $12,318.06 | $16,486.24 | $20,251.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,802.59 / $24,204.50
| Facility | | $3,775.00 | $16,802.59 | $24,204.50 |