- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,826.80 / $26,838.30 / $47,262.30
| Facility | | $16,826.80 | $26,838.30 | $47,262.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,475.77 / $22,509.39 / $32,722.21
| Facility | | $9,475.77 | $22,509.39 | $32,722.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,559.06 / $20,868.21 / $34,959.12
| Facility | | $15,559.06 | $20,868.21 | $34,959.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,353.10 / $18,008.09 / $23,304.60
| Facility | | $12,353.10 | $18,008.09 | $23,304.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $20,257.16 / $30,623.42
| Facility | | $6,746.00 | $20,257.16 | $30,623.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,473.73 / $21,755.80 / $29,549.46
| Facility | | $15,473.73 | $21,755.80 | $29,549.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,810.50 / $43,791.82
| Facility | | $3,775.00 | $16,810.50 | $43,791.82 |