- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,735.60 / $23,507.10 / $39,689.40
| Facility | | $10,735.60 | $23,507.10 | $39,689.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,013.58 / $43,054.15 / $55,827.98
| Facility | | $29,013.58 | $43,054.15 | $55,827.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,434.05 / $33,509.78 / $49,190.48
| Facility | | $23,434.05 | $33,509.78 | $49,190.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,244.13 / $33,135.00 / $69,485.14
| Facility | | $17,244.13 | $33,135.00 | $69,485.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,434.05 / $36,484.12 / $49,461.67
| Facility | | $23,434.05 | $36,484.12 | $49,461.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,789.17 / $30,856.20 / $46,386.85
| Facility | | $6,789.17 | $30,856.20 | $46,386.85 |