- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,623.60 / $22,998.90 / $40,471.30
| Facility | | $13,623.60 | $22,998.90 | $40,471.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,628.00 / $7,884.00 / $28,908.00
| Facility | | $2,628.00 | $7,884.00 | $28,908.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,209.80 / $16,546.77 / $27,359.16
| Facility | | $11,209.80 | $16,546.77 | $27,359.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,392.78 / $20,879.00 / $29,167.83
| Facility | | $12,392.78 | $20,879.00 | $29,167.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,088.05 / $44,088.05 / $51,741.07
| Facility | | $44,088.05 | $44,088.05 | $51,741.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $20,043.31 / $28,629.57
| Facility | | $1,787.00 | $20,043.31 | $28,629.57 |