- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,110.20 / $32,169.50 / $52,976.20
| Facility | | $13,110.20 | $32,169.50 | $52,976.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,926.83 / $53,312.93 / $69,130.46
| Facility | | $35,926.83 | $53,312.93 | $69,130.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $42,514.13 / $67,975.61
| Facility | | $17,646.00 | $42,514.13 | $67,975.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,835.29 / $45,800.08 / $96,044.21
| Facility | | $23,835.29 | $45,800.08 | $96,044.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $45,497.63 / $67,992.39
| Facility | | $17,648.00 | $45,497.63 | $67,992.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $37,402.43 / $62,701.67
| Facility | | $5,281.00 | $37,402.43 | $62,701.67 |