- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,744.80 / $34,168.80 / $56,268.60
| Facility | | $13,744.80 | $34,168.80 | $56,268.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,802.58 / $55,897.06 / $71,851.17
| Facility | | $36,802.58 | $55,897.06 | $71,851.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $45,156.30 / $72,200.16
| Facility | | $17,646.00 | $45,156.30 | $72,200.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,316.60 / $48,646.47 / $102,013.18
| Facility | | $25,316.60 | $48,646.47 | $102,013.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,019.23 / $18,019.23 / $21,059.05
| Facility | | $18,019.23 | $18,019.23 | $21,059.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $48,325.22 / $72,217.99
| Facility | | $17,648.00 | $48,325.22 | $72,217.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $32,334.58 / $62,111.95
| Facility | | $5,281.00 | $32,334.58 | $62,111.95 |