- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,605.00 / $16,390.80 / $19,791.50
| Facility | | $8,605.00 | $16,390.80 | $19,791.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,800.60 / $25,252.34
| Facility | | $6,916.00 | $14,800.60 | $25,252.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,509.24 / $14,134.50 / $17,972.86
| Facility | | $12,509.24 | $14,134.50 | $17,972.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,127.70 / $11,864.30 / $15,353.80
| Facility | | $8,127.70 | $11,864.30 | $15,353.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,714.17 / $14,923.09 / $23,376.30
| Facility | | $8,714.17 | $14,923.09 | $23,376.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,576.21 / $13,362.87 / $18,027.90
| Facility | | $9,576.21 | $13,362.87 | $18,027.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,495.39 / $19,440.41
| Facility | | $3,775.00 | $13,495.39 | $19,440.41 |