- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,123.60 / $27,509.00 / $45,794.90
| Facility | | $11,123.60 | $27,509.00 | $45,794.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,446.37 / $46,664.25 / $60,509.17
| Facility | | $31,446.37 | $46,664.25 | $60,509.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $36,071.69 / $57,674.84
| Facility | | $17,646.00 | $36,071.69 | $57,674.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,223.38 / $38,859.71 / $81,490.03
| Facility | | $20,223.38 | $38,859.71 | $81,490.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,936.83 / $14,936.83 / $14,936.83
| Facility | | $14,936.83 | $14,936.83 | $14,936.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $38,603.08 / $57,689.08
| Facility | | $17,648.00 | $38,603.08 | $57,689.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $25,829.47 / $49,616.18
| Facility | | $5,281.00 | $25,829.47 | $49,616.18 |