- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $24,547.09 / $48,977.88
| Facility | | $20,892.96 | $24,547.09 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $21,379.62 / $30,199.52
| Facility | | $12,882.50 | $21,379.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $18,197.01 / $27,542.29
| Facility | | $15,488.17 | $18,197.01 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $14,454.40 / $19,054.61
| Facility | | $12,302.69 | $14,454.40 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $19,054.61 / $30,199.52
| Facility | | $14,791.08 | $19,054.61 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,218.10 / $21,379.62
| Facility | | $11,220.18 | $16,218.10 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $19,498.45 / $23,988.33
| Facility | | $15,135.61 | $19,498.45 | $23,988.33 |