- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,597.50 / $27,805.30 / $33,574.30
| Facility | | $14,597.50 | $27,805.30 | $33,574.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $25,107.70 / $40,487.47
| Facility | | $12,397.00 | $25,107.70 | $40,487.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,575.20 / $22,967.12 / $26,998.02
| Facility | | $17,575.20 | $22,967.12 | $26,998.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,886.79 / $18,774.80 / $24,339.90
| Facility | | $11,886.79 | $18,774.80 | $24,339.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,870.22 / $23,479.92 / $35,917.19
| Facility | | $13,870.22 | $23,479.92 | $35,917.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,353.71 / $21,280.18 / $27,295.71
| Facility | | $15,353.71 | $21,280.18 | $27,295.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $24,531.97 / $35,296.76
| Facility | | $3,775.00 | $24,531.97 | $35,296.76 |