- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,059.50 / $22,046.60 / $38,795.60
| Facility | | $13,059.50 | $22,046.60 | $38,795.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,256.00 / $21,266.13 / $37,914.85
| Facility | | $5,256.00 | $21,266.13 | $37,914.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,006.86 / $20,506.64 / $34,496.01
| Facility | | $14,006.86 | $20,506.64 | $34,496.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,879.65 / $20,088.65 / $28,060.42
| Facility | | $11,879.65 | $20,088.65 | $28,060.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,837.25 / $42,837.25 / $50,273.15
| Facility | | $42,837.25 | $42,837.25 | $50,273.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $19,213.40 / $27,444.14
| Facility | | $1,787.00 | $19,213.40 | $27,444.14 |