- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,281.30 / $28,397.70 / $48,823.70
| Facility | | $12,281.30 | $28,397.70 | $48,823.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,861.19 / $47,945.78 / $72,306.00
| Facility | | $29,861.19 | $47,945.78 | $72,306.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,309.49 / $40,481.47 / $59,424.52
| Facility | | $28,309.49 | $40,481.47 | $59,424.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,831.75 / $40,028.71 / $83,941.48
| Facility | | $20,831.75 | $40,028.71 | $83,941.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,309.49 / $44,074.61 / $59,752.13
| Facility | | $28,309.49 | $44,074.61 | $59,752.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,792.00 / $36,319.06 / $60,636.00
| Facility | | $7,792.00 | $36,319.06 | $60,636.00 |