- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,329.70 / $21,563.00 / $36,119.50
| Facility | | $10,329.70 | $21,563.00 | $36,119.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,091.85 / $35,750.65 / $46,357.59
| Facility | | $24,091.85 | $35,750.65 | $46,357.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,575.88 / $28,986.39 / $46,346.18
| Facility | | $15,575.88 | $28,986.39 | $46,346.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,251.04 / $31,226.77 / $65,483.52
| Facility | | $16,251.04 | $31,226.77 | $65,483.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,647.00 / $31,020.56 / $46,357.62
| Facility | | $17,647.00 | $31,020.56 | $46,357.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $20,946.68 / $39,870.43
| Facility | | $5,281.00 | $20,946.68 | $39,870.43 |