- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,827.50 / $28,243.40 / $34,103.30
| Facility | | $14,827.50 | $28,243.40 | $34,103.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $25,503.30 / $43,776.71
| Facility | | $12,397.00 | $25,503.30 | $43,776.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,978.76 / $23,763.30 / $28,486.66
| Facility | | $20,978.76 | $23,763.30 | $28,486.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,609.74 / $21,681.80 / $28,058.80
| Facility | | $12,609.74 | $21,681.80 | $28,058.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,643.60 / $26,639.91 / $40,565.65
| Facility | | $15,643.60 | $26,639.91 | $40,565.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,340.80 / $24,349.35 / $30,976.09
| Facility | | $17,340.80 | $24,349.35 | $30,976.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $24,918.50 / $35,852.90
| Facility | | $3,775.00 | $24,918.50 | $35,852.90 |