- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,693.80 / $27,988.70 / $33,795.60
| Facility | | $14,693.80 | $27,988.70 | $33,795.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $25,273.25 / $41,794.69
| Facility | | $12,397.00 | $25,273.25 | $41,794.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,096.20 / $23,207.90 / $26,670.14
| Facility | | $19,096.20 | $23,207.90 | $26,670.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,760.97 / $19,364.70 / $25,125.77
| Facility | | $12,760.97 | $19,364.70 | $25,125.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,313.88 / $24,189.20 / $37,347.48
| Facility | | $14,313.88 | $24,189.20 | $37,347.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,849.44 / $21,967.26 / $28,548.92
| Facility | | $15,849.44 | $21,967.26 | $28,548.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $24,693.73 / $35,529.49
| Facility | | $3,775.00 | $24,693.73 | $35,529.49 |