- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,566.70 / $20,947.70 / $35,368.10
| Facility | | $9,566.70 | $20,947.70 | $35,368.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,309.75 / $34,027.44 / $44,123.13
| Facility | | $23,309.75 | $34,027.44 | $44,123.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,882.57 / $29,861.26 / $43,834.66
| Facility | | $20,882.57 | $29,861.26 | $43,834.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,366.60 / $29,527.29 / $61,919.65
| Facility | | $15,366.60 | $29,527.29 | $61,919.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,882.57 / $32,511.75 / $44,076.32
| Facility | | $20,882.57 | $32,511.75 | $44,076.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,049.97 / $27,566.33 / $41,336.28
| Facility | | $6,049.97 | $27,566.33 | $41,336.28 |