- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,072.80 / $35,205.60 / $61,997.10
| Facility | | $22,072.80 | $35,205.60 | $61,997.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,695.43 / $30,950.41 / $45,362.80
| Facility | | $12,695.43 | $30,950.41 | $45,362.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,409.87 / $27,374.24 / $45,858.24
| Facility | | $20,409.87 | $27,374.24 | $45,858.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,572.77 / $24,159.44 / $29,731.36
| Facility | | $16,572.77 | $24,159.44 | $29,731.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,509.61 / $27,373.45 / $42,453.25
| Facility | | $8,509.61 | $27,373.45 | $42,453.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,451.24 / $30,047.50 / $40,851.21
| Facility | | $21,451.24 | $30,047.50 | $40,851.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $22,051.47 / $57,444.68
| Facility | | $3,775.00 | $22,051.47 | $57,444.68 |