- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,052.80 / $22,035.30 / $38,775.69
| Facility | | $13,052.80 | $22,035.30 | $38,775.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,487.77 / $11,487.77 / $11,487.77
| Facility | | $11,487.77 | $11,487.77 | $11,487.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,696.16 / $12,557.50 / $20,486.95
| Facility | | $8,696.16 | $12,557.50 | $20,486.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,873.56 / $20,079.29 / $28,046.05
| Facility | | $11,873.56 | $20,079.29 | $28,046.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,417.60 / $43,417.60 / $50,954.24
| Facility | | $43,417.60 | $43,417.60 | $50,954.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $19,203.56 / $27,430.09
| Facility | | $1,787.00 | $19,203.56 | $27,430.09 |