- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,436.60 / $40,570.80 / $71,445.20
| Facility | | $25,436.60 | $40,570.80 | $71,445.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,344.78 / $33,671.79 / $49,168.24
| Facility | | $14,344.78 | $33,671.79 | $49,168.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,520.24 / $31,545.95 / $52,846.84
| Facility | | $23,520.24 | $31,545.95 | $52,846.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,310.57 / $25,414.95 / $30,728.03
| Facility | | $15,310.57 | $25,414.95 | $30,728.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,233.17 / $30,663.82 / $45,809.55
| Facility | | $9,233.17 | $30,663.82 | $45,809.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,147.15 / $32,753.67 / $44,567.21
| Facility | | $23,147.15 | $32,753.67 | $44,567.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $25,412.02 / $69,433.86
| Facility | | $3,775.00 | $25,412.02 | $69,433.86 |