- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,721.20 / $24,231.40 / $29,258.90
| Facility | | $12,721.20 | $24,231.40 | $29,258.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,880.55 / $37,450.73
| Facility | | $6,916.00 | $21,880.55 | $37,450.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,610.60 / $20,410.40 / $24,224.14
| Facility | | $14,610.60 | $20,410.40 | $24,224.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,647.44 / $15,976.60 / $22,514.29
| Facility | | $9,647.44 | $15,976.60 | $22,514.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,842.50 / $21,347.16 / $33,223.24
| Facility | | $12,842.50 | $21,347.16 | $33,223.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,202.11 / $19,368.31 / $23,360.23
| Facility | | $14,202.11 | $19,368.31 | $23,360.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,950.99 / $28,739.85
| Facility | | $3,775.00 | $19,950.99 | $28,739.85 |