- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,673.80 / $35,569.80 / $42,949.60
| Facility | | $18,673.80 | $35,569.80 | $42,949.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $32,118.85 / $52,627.10
| Facility | | $12,397.00 | $32,118.85 | $52,627.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,261.60 / $29,222.95 / $33,024.44
| Facility | | $21,261.60 | $29,222.95 | $33,024.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,851.90 / $24,063.80 / $31,637.89
| Facility | | $14,851.90 | $24,063.80 | $31,637.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,978.66 / $31,075.80 / $47,945.52
| Facility | | $17,978.66 | $31,075.80 | $47,945.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,957.31 / $27,413.23 / $36,650.21
| Facility | | $19,957.31 | $27,413.23 | $36,650.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $31,382.36 / $45,153.13
| Facility | | $3,775.00 | $31,382.36 | $45,153.13 |