- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,103.80 / $28,769.60 / $34,738.60
| Facility | | $15,103.80 | $28,769.60 | $34,738.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $25,978.45 / $47,170.91
| Facility | | $12,397.00 | $25,978.45 | $47,170.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,350.54 / $24,258.82 / $28,131.42
| Facility | | $21,350.54 | $24,258.82 | $28,131.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,888.78 / $23,949.75 / $31,933.00
| Facility | | $15,888.78 | $23,949.75 | $31,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,858.97 / $29,190.33 / $44,592.31
| Facility | | $16,858.97 | $29,190.33 | $44,592.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,695.71 / $26,251.86 / $37,687.94
| Facility | | $18,695.71 | $26,251.86 | $37,687.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $25,382.76 / $36,520.87
| Facility | | $3,775.00 | $25,382.76 | $36,520.87 |