- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,518.80 / $25,205.80 / $41,721.40
| Facility | | $10,518.80 | $25,205.80 | $41,721.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,158.13 / $41,784.72 / $54,181.93
| Facility | | $28,158.13 | $41,784.72 | $54,181.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $33,481.94 / $53,534.12
| Facility | | $17,646.00 | $33,481.94 | $53,534.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,771.45 / $36,069.80 / $75,639.52
| Facility | | $18,771.45 | $36,069.80 | $75,639.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $35,831.61 / $53,547.33
| Facility | | $17,648.00 | $35,831.61 | $53,547.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $23,975.06 / $46,054.03
| Facility | | $5,281.00 | $23,975.06 | $46,054.03 |