- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,543.80 / $25,798.10 / $31,150.60
| Facility | | $13,543.80 | $25,798.10 | $31,150.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $23,295.25 / $39,986.57
| Facility | | $6,916.00 | $23,295.25 | $39,986.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,857.16 / $21,698.68 / $26,344.58
| Facility | | $18,857.16 | $21,698.68 | $26,344.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,353.10 / $18,008.09 / $24,041.88
| Facility | | $12,353.10 | $18,008.09 | $24,041.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,703.71 / $23,097.98 / $35,477.43
| Facility | | $13,703.71 | $23,097.98 | $35,477.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,165.72 / $20,751.82 / $26,141.57
| Facility | | $15,165.72 | $20,751.82 | $26,141.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,240.93 / $30,598.04
| Facility | | $3,775.00 | $21,240.93 | $30,598.04 |