- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,785.09 / $29,961.80 / $52,762.80
| Facility | | $18,785.09 | $29,961.80 | $52,762.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,754.77 / $25,137.94 / $36,543.36
| Facility | | $9,754.77 | $25,137.94 | $36,543.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,369.86 / $23,296.90 / $39,027.74
| Facility | | $17,369.86 | $23,296.90 | $39,027.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,146.14 / $20,529.20 / $25,378.02
| Facility | | $14,146.14 | $20,529.20 | $25,378.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,317.67 / $22,756.75 / $34,199.48
| Facility | | $7,317.67 | $22,756.75 | $34,199.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,280.68 / $24,452.51 / $33,272.00
| Facility | | $17,280.68 | $24,452.51 | $33,272.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,766.93 / $48,888.40
| Facility | | $3,775.00 | $18,766.93 | $48,888.40 |