- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,893.80 / $30,274.40 / $36,555.60
| Facility | | $15,893.80 | $30,274.40 | $36,555.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $27,337.25 / $45,709.06
| Facility | | $6,916.00 | $27,337.25 | $45,709.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,907.12 / $25,381.47 / $30,173.44
| Facility | | $21,907.12 | $25,381.47 | $30,173.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,327.17 / $21,468.15 / $28,624.20
| Facility | | $14,327.17 | $21,468.15 | $28,624.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,637.38 / $26,983.31 / $40,549.36
| Facility | | $15,637.38 | $26,983.31 | $40,549.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,333.84 / $23,900.37 / $29,995.31
| Facility | | $17,333.84 | $23,900.37 | $29,995.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $24,926.49 / $35,907.16
| Facility | | $3,775.00 | $24,926.49 | $35,907.16 |