- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,012.10 / $33,513.80 / $59,017.90
| Facility | | $21,012.10 | $33,513.80 | $59,017.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.51 / $25,256.58 / $36,763.31
| Facility | | $9,120.51 | $25,256.58 | $36,763.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,429.08 / $26,058.78 / $43,654.55
| Facility | | $19,429.08 | $26,058.78 | $43,654.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,662.86 / $21,375.22 / $26,305.01
| Facility | | $14,662.86 | $21,375.22 | $26,305.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $22,021.34 / $35,046.90
| Facility | | $6,600.00 | $22,021.34 | $35,046.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,763.79 / $24,882.36 / $33,760.78
| Facility | | $17,763.79 | $24,882.36 | $33,760.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,991.80 / $57,356.38
| Facility | | $3,775.00 | $20,991.80 | $57,356.38 |