- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $27,542.29 / $41,686.94
| Facility | | $22,908.68 | $27,542.29 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $20,417.38 / $42,657.95
| Facility | | $19,054.61 | $20,417.38 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $28,840.32 / $47,863.01
| Facility | | $12,302.69 | $28,840.32 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $151,356.12
| Facility | | $23,988.33 | $23,988.33 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $30,199.52 / $44,668.36
| Facility | | $22,387.21 | $30,199.52 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $30,199.52 / $47,863.01
| Facility | | $15,848.93 | $30,199.52 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $26,915.35 / $42,657.95
| Facility | | $18,620.87 | $26,915.35 | $42,657.95 |