- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,650.10 / $31,179.80 / $55,783.20
| Facility | | $12,650.10 | $31,179.80 | $55,783.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,417.69 / $50,590.89 / $68,623.00
| Facility | | $34,417.69 | $50,590.89 | $68,623.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,946.08 / $44,251.69 / $64,959.00
| Facility | | $30,946.08 | $44,251.69 | $64,959.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,771.91 / $43,756.77 / $91,759.33
| Facility | | $22,771.91 | $43,756.77 | $91,759.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,518.75 / $16,518.75 / $16,518.75
| Facility | | $16,518.75 | $16,518.75 | $16,518.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,946.08 / $48,179.48 / $65,317.12
| Facility | | $30,946.08 | $48,179.48 | $65,317.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,965.51 / $39,701.62 / $64,199.00
| Facility | | $8,965.51 | $39,701.62 | $64,199.00 |