- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,734.20 / $34,665.60 / $61,046.20
| Facility | | $21,734.20 | $34,665.60 | $61,046.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,196.02 / $29,599.96 / $43,561.81
| Facility | | $12,196.02 | $29,599.96 | $43,561.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,096.82 / $26,954.37 / $45,154.87
| Facility | | $20,096.82 | $26,954.37 | $45,154.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,593.75 / $24,711.20 / $31,998.47
| Facility | | $17,593.75 | $24,711.20 | $31,998.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,092.80 / $27,167.36 / $40,269.94
| Facility | | $7,092.80 | $27,167.36 | $40,269.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,348.03 / $29,005.96 / $39,448.10
| Facility | | $20,348.03 | $29,005.96 | $39,448.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,713.24 / $59,327.60
| Facility | | $3,775.00 | $21,713.24 | $59,327.60 |