- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,376.20 / $25,479.10 / $30,765.40
| Facility | | $13,376.20 | $25,479.10 | $30,765.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $23,007.15 / $39,492.04
| Facility | | $6,916.00 | $23,007.15 | $39,492.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,025.91 / $21,430.34 / $25,192.50
| Facility | | $19,025.91 | $21,430.34 | $25,192.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,463.30 / $18,956.70 / $24,532.20
| Facility | | $13,463.30 | $18,956.70 | $24,532.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,709.92 / $23,646.49 / $35,646.48
| Facility | | $13,709.92 | $23,646.49 | $35,646.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,174.07 / $20,918.14 / $27,248.65
| Facility | | $15,174.07 | $20,918.14 | $27,248.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,978.24 / $30,219.62
| Facility | | $3,775.00 | $20,978.24 | $30,219.62 |