- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,993.50 / $33,484.10 / $58,965.50
| Facility | | $20,993.50 | $33,484.10 | $58,965.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,864.82 / $30,821.61 / $43,872.77
| Facility | | $10,864.82 | $30,821.61 | $43,872.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,411.84 / $26,035.67 / $43,615.83
| Facility | | $19,411.84 | $26,035.67 | $43,615.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,091.57 / $24,010.80 / $29,363.07
| Facility | | $16,091.57 | $24,010.80 | $29,363.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,755.45 / $26,304.87 / $42,630.44
| Facility | | $8,755.45 | $26,304.87 | $42,630.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,118.93 / $30,323.23 / $41,573.65
| Facility | | $22,118.93 | $30,323.23 | $41,573.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,973.18 / $54,635.70
| Facility | | $3,775.00 | $20,973.18 | $54,635.70 |