- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,097.28 / $47,972.40 / $57,925.50
| Facility | | $22,097.28 | $47,972.40 | $57,925.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $42,617.05 / $60,242.52
| Facility | | $12,397.00 | $42,617.05 | $60,242.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,921.59 / $37,702.98 / $43,726.90
| Facility | | $18,921.59 | $37,702.98 | $43,726.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,229.78 / $20,383.00 / $26,378.00
| Facility | | $14,229.78 | $20,383.00 | $26,378.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,594.74 / $27,343.76 / $42,725.88
| Facility | | $14,594.74 | $27,343.76 | $42,725.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,164.14 / $23,379.24 / $32,660.24
| Facility | | $16,164.14 | $23,379.24 | $32,660.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $42,324.90 / $60,897.33
| Facility | | $3,775.00 | $42,324.90 | $60,897.33 |