- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,690.90 / $17,051.70 / $30,028.00
| Facility | | $10,690.90 | $17,051.70 | $30,028.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,066.00 / $14,519.12 / $21,280.11
| Facility | | $7,066.00 | $14,519.12 | $21,280.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,885.42 / $13,258.58 / $22,211.23
| Facility | | $9,885.42 | $13,258.58 | $22,211.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,127.70 / $11,848.40 / $14,581.01
| Facility | | $8,127.70 | $11,848.40 | $14,581.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,236.24 / $12,809.30 / $19,915.21
| Facility | | $6,236.24 | $12,809.30 | $19,915.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,062.96 / $14,095.56 / $19,163.68
| Facility | | $10,062.96 | $14,095.56 | $19,163.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $10,680.53 / $27,823.06
| Facility | | $3,775.00 | $10,680.53 | $27,823.06 |