- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,709.40 / $34,626.00 / $60,976.40
| Facility | | $21,709.40 | $34,626.00 | $60,976.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,441.79 / $26,874.92 / $40,127.90
| Facility | | $11,441.79 | $26,874.92 | $40,127.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,073.84 / $26,923.55 / $45,103.24
| Facility | | $20,073.84 | $26,923.55 | $45,103.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,974.04 / $22,934.70 / $28,944.14
| Facility | | $15,974.04 | $22,934.70 | $28,944.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,122.20 / $25,053.95 / $36,562.58
| Facility | | $8,122.20 | $25,053.95 | $36,562.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,474.74 / $26,733.41 / $36,379.56
| Facility | | $18,474.74 | $26,733.41 | $36,379.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,688.42 / $59,259.78
| Facility | | $3,775.00 | $21,688.42 | $59,259.78 |