- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,801.00 / $34,772.10 / $61,233.80
| Facility | | $21,801.00 | $34,772.10 | $61,233.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,434.10 / $30,238.98 / $43,689.28
| Facility | | $12,434.10 | $30,238.98 | $43,689.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,158.57 / $27,037.19 / $45,293.61
| Facility | | $20,158.57 | $27,037.19 | $45,293.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,527.36 / $27,008.80 / $33,237.87
| Facility | | $18,527.36 | $27,008.80 | $33,237.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,555.06 / $26,168.16 / $41,646.55
| Facility | | $8,555.06 | $26,168.16 | $41,646.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,441.14 / $29,638.24 / $40,299.71
| Facility | | $21,441.14 | $29,638.24 | $40,299.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,779.96 / $56,737.38
| Facility | | $3,775.00 | $21,779.96 | $56,737.38 |