- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,407.59 / $27,764.70 / $48,893.70
| Facility | | $17,407.59 | $27,764.70 | $48,893.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,689.92 / $24,739.89 / $36,060.44
| Facility | | $8,689.92 | $24,739.89 | $36,060.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,096.12 / $21,588.53 / $36,165.83
| Facility | | $16,096.12 | $21,588.53 | $36,165.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,151.45 / $19,602.70 / $23,099.15
| Facility | | $12,151.45 | $19,602.70 | $23,099.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $21,598.46 / $34,373.89
| Facility | | $6,600.00 | $21,598.46 | $34,373.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,400.38 / $24,373.32 / $33,115.32
| Facility | | $17,400.38 | $24,373.32 | $33,115.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $17,390.75 / $45,303.42
| Facility | | $3,775.00 | $17,390.75 | $45,303.42 |