- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,828.80 / $28,245.80 / $34,106.10
| Facility | | $14,828.80 | $28,245.80 | $34,106.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $25,505.45 / $43,780.40
| Facility | | $6,916.00 | $25,505.45 | $43,780.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,356.40 / $23,757.44 / $28,884.76
| Facility | | $18,356.40 | $23,757.44 | $28,884.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,984.18 / $19,390.20 / $26,991.10
| Facility | | $11,984.18 | $19,390.20 | $26,991.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,362.75 / $25,505.45 / $39,829.44
| Facility | | $15,362.75 | $25,505.45 | $39,829.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,026.09 / $23,169.59 / $28,529.11
| Facility | | $17,026.09 | $23,169.59 | $28,529.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $23,256.23 / $33,501.11
| Facility | | $3,775.00 | $23,256.23 | $33,501.11 |