- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,082.70 / $24,056.60 / $42,363.70
| Facility | | $15,082.70 | $24,056.60 | $42,363.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,369.32 / $20,086.43 / $29,199.92
| Facility | | $7,369.32 | $20,086.43 | $29,199.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,946.43 / $18,705.31 / $31,335.77
| Facility | | $13,946.43 | $18,705.31 | $31,335.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,611.61 / $15,955.50 / $19,037.11
| Facility | | $10,611.61 | $15,955.50 | $19,037.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $18,008.65 / $27,327.05
| Facility | | $6,409.00 | $18,008.65 | $27,327.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,808.11 / $19,341.50 / $26,295.82
| Facility | | $13,808.11 | $19,341.50 | $26,295.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,983.26 / $21,226.55 / $29,766.31
| Facility | | $7,983.26 | $21,226.55 | $29,766.31 |