- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,136.70 / $23,865.10 / $41,995.70
| Facility | | $14,136.70 | $23,865.10 | $41,995.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.00 / $12,321.91 / $23,761.12
| Facility | | $5,840.00 | $12,321.91 | $23,761.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,763.64 / $24,018.96 / $39,492.81
| Facility | | $16,763.64 | $24,018.96 | $39,492.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,859.54 / $21,633.08 / $30,082.38
| Facility | | $12,859.54 | $21,633.08 | $30,082.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,947.60 / $43,947.60 / $51,576.24
| Facility | | $43,947.60 | $43,947.60 | $51,576.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $20,798.22 / $29,707.88
| Facility | | $1,787.00 | $20,798.22 | $29,707.88 |