- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,764.90 / $29,929.60 / $52,706.00
| Facility | | $18,764.90 | $29,929.60 | $52,706.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,021.68 / $28,983.36 / $41,754.86
| Facility | | $10,021.68 | $28,983.36 | $41,754.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,351.18 / $23,271.86 / $38,985.80
| Facility | | $17,351.18 | $23,271.86 | $38,985.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,888.78 / $23,949.75 / $28,504.29
| Facility | | $15,888.78 | $23,949.75 | $28,504.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,834.14 / $25,018.75 / $39,817.26
| Facility | | $6,834.14 | $25,018.75 | $39,817.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,584.54 / $28,454.15 / $38,689.68
| Facility | | $20,584.54 | $28,454.15 | $38,689.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,992.90 / $11,500.68 / $27,088.88
| Facility | | $7,992.90 | $11,500.68 | $27,088.88 |