- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,028.70 / $28,626.80 / $34,566.10
| Facility | | $15,028.70 | $28,626.80 | $34,566.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $25,849.45 / $43,505.86
| Facility | | $12,397.00 | $25,849.45 | $43,505.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,249.62 / $24,145.40 / $28,012.76
| Facility | | $21,249.62 | $24,145.40 | $28,012.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,225.90 / $20,818.20 / $59,999.40
| Facility | | $15,225.90 | $20,818.20 | $59,999.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,139.39 / $25,726.14 / $40,906.85
| Facility | | $13,139.39 | $25,726.14 | $40,906.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,498.34 / $23,166.39 / $29,913.58
| Facility | | $16,498.34 | $23,166.39 | $29,913.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $25,256.72 / $36,339.51
| Facility | | $3,775.00 | $25,256.72 | $36,339.51 |