- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,865.00 / $32,124.50 / $38,789.50
| Facility | | $16,865.00 | $32,124.50 | $38,789.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $29,007.80 / $52,669.38
| Facility | | $12,397.00 | $29,007.80 | $52,669.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,709.08 / $27,019.76 / $31,681.16
| Facility | | $23,709.08 | $27,019.76 | $31,681.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,806.28 / $25,072.45 / $33,092.62
| Facility | | $15,806.28 | $25,072.45 | $33,092.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,797.59 / $31,007.12 / $48,833.18
| Facility | | $18,797.59 | $31,007.12 | $48,833.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,874.97 / $28,286.68 / $34,916.51
| Facility | | $20,874.97 | $28,286.68 | $34,916.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $29,152.16 / $40,779.57
| Facility | | $3,775.00 | $29,152.16 | $40,779.57 |