- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,990.60 / $30,106.90 / $50,011.80
| Facility | | $11,990.60 | $30,106.90 | $50,011.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,002.00 / $50,920.56 / $68,604.46
| Facility | | $35,002.00 | $50,920.56 | $68,604.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,013.37 / $42,917.96 / $63,001.15
| Facility | | $30,013.37 | $42,917.96 | $63,001.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,085.57 / $42,645.31 / $88,993.73
| Facility | | $22,085.57 | $42,645.31 | $88,993.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,216.86 / $17,216.86 / $17,216.86
| Facility | | $17,216.86 | $17,216.86 | $17,216.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,013.37 / $46,727.37 / $63,348.48
| Facility | | $30,013.37 | $46,727.37 | $63,348.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,695.29 / $39,519.36 / $60,460.00
| Facility | | $8,695.29 | $39,519.36 | $60,460.00 |