- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,283.80 / $21,493.30 / $25,952.60
| Facility | | $11,283.80 | $21,493.30 | $25,952.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $19,408.05 / $35,239.40
| Facility | | $6,916.00 | $19,408.05 | $35,239.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,004.77 / $18,428.34 / $22,058.38
| Facility | | $16,004.77 | $18,428.34 | $22,058.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,540.05 / $16,143.20 / $22,141.23
| Facility | | $10,540.05 | $16,143.20 | $22,141.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,632.47 / $20,559.98 / $29,588.50
| Facility | | $12,632.47 | $20,559.98 | $29,588.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,966.78 / $16,349.90 / $22,854.99
| Facility | | $13,966.78 | $16,349.90 | $22,854.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,566.00 / $20,061.59 / $24,463.17
| Facility | | $11,566.00 | $20,061.59 | $24,463.17 |