- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,961.90 / $27,053.80 / $47,641.80
| Facility | | $16,961.90 | $27,053.80 | $47,641.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,592.27 / $19,488.02 / $29,253.33
| Facility | | $8,592.27 | $19,488.02 | $29,253.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,683.99 / $21,035.77 / $35,239.83
| Facility | | $15,683.99 | $21,035.77 | $35,239.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,356.78 / $18,808.12 / $23,145.86
| Facility | | $12,356.78 | $18,808.12 | $23,145.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $16,789.52 / $27,543.85
| Facility | | $6,600.00 | $16,789.52 | $27,543.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,291.21 / $19,592.07 / $26,861.06
| Facility | | $14,291.21 | $19,592.07 | $26,861.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,224.90 / $10,491.72 / $24,486.03
| Facility | | $7,224.90 | $10,491.72 | $24,486.03 |