- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,310.80 / $21,230.40 / $37,386.69
| Facility | | $13,310.80 | $21,230.40 | $37,386.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,729.52 / $18,059.96 / $26,254.01
| Facility | | $6,729.52 | $18,059.96 | $26,254.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,307.96 / $16,507.75 / $27,654.33
| Facility | | $12,307.96 | $16,507.75 | $27,654.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,595.15 / $13,061.40 / $16,481.07
| Facility | | $8,595.15 | $13,061.40 | $16,481.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $16,379.97 / $24,570.09
| Facility | | $6,409.00 | $16,379.97 | $24,570.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,415.04 / $17,567.53 / $23,903.75
| Facility | | $12,415.04 | $17,567.53 | $23,903.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,297.91 / $34,641.41
| Facility | | $3,775.00 | $13,297.91 | $34,641.41 |