- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,328.50 / $29,233.60 / $51,480.30
| Facility | | $18,328.50 | $29,233.60 | $51,480.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,497.16 / $24,494.89 / $35,890.74
| Facility | | $9,497.16 | $24,494.89 | $35,890.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,947.66 / $22,730.65 / $38,079.15
| Facility | | $16,947.66 | $22,730.65 | $38,079.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,379.66 / $19,504.59 / $24,002.96
| Facility | | $13,379.66 | $19,504.59 | $24,002.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $21,665.53 / $33,588.73
| Facility | | $6,600.00 | $21,665.53 | $33,588.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,972.07 / $23,773.38 / $32,321.20
| Facility | | $16,972.07 | $23,773.38 | $32,321.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,310.80 / $50,031.04
| Facility | | $3,775.00 | $18,310.80 | $50,031.04 |