- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,014.60 / $44,682.60 / $78,686.10
| Facility | | $28,014.60 | $44,682.60 | $78,686.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,069.97 / $41,551.37 / $60,610.80
| Facility | | $14,069.97 | $41,551.37 | $60,610.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,904.00 / $34,743.11 / $58,202.83
| Facility | | $25,904.00 | $34,743.11 | $58,202.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,608.39 / $33,668.25 / $40,559.21
| Facility | | $22,608.39 | $33,668.25 | $40,559.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,072.65 / $36,753.15 / $56,723.25
| Facility | | $10,072.65 | $36,753.15 | $56,723.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,661.74 / $40,147.50 / $54,582.71
| Facility | | $28,661.74 | $40,147.50 | $54,582.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $27,987.51 / $76,470.92
| Facility | | $3,775.00 | $27,987.51 | $76,470.92 |