- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,678.20 / $32,981.30 / $58,080.00
| Facility | | $20,678.20 | $32,981.30 | $58,080.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,620.20 / $27,575.58 / $40,976.50
| Facility | | $9,620.20 | $27,575.58 | $40,976.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,120.34 / $25,644.69 / $42,960.85
| Facility | | $19,120.34 | $25,644.69 | $42,960.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,156.66 / $22,095.08 / $27,190.89
| Facility | | $15,156.66 | $22,095.08 | $27,190.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,747.03 / $25,555.03 / $37,515.83
| Facility | | $7,747.03 | $25,555.03 | $37,515.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,956.40 / $27,284.63 / $37,107.08
| Facility | | $18,956.40 | $27,284.63 | $37,107.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,658.22 / $53,815.24
| Facility | | $3,775.00 | $20,658.22 | $53,815.24 |