- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,390.85 / $20,562.59 / $34,717.90
| Facility | | $9,390.85 | $20,562.59 | $34,717.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,510.63 / $33,404.23 / $43,315.00
| Facility | | $22,510.63 | $33,404.23 | $43,315.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,498.72 / $29,312.37 / $43,028.91
| Facility | | $20,498.72 | $29,312.37 | $43,028.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,084.14 / $28,984.53 / $60,781.48
| Facility | | $15,084.14 | $28,984.53 | $60,781.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,596.08 / $10,596.08 / $10,596.08
| Facility | | $10,596.08 | $10,596.08 | $10,596.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,498.72 / $31,914.14 / $43,266.13
| Facility | | $20,498.72 | $31,914.14 | $43,266.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,938.77 / $26,991.17 / $40,576.46
| Facility | | $5,938.77 | $26,991.17 | $40,576.46 |