- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,648.70 / $29,807.70 / $35,992.10
| Facility | | $15,648.70 | $29,807.70 | $35,992.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $26,915.85 / $37,431.81
| Facility | | $12,397.00 | $26,915.85 | $37,431.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,919.09 / $24,503.62 / $29,785.86
| Facility | | $19,919.09 | $24,503.62 | $29,785.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,441.54 / $18,183.00 / $25,099.63
| Facility | | $13,441.54 | $18,183.00 | $25,099.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,833.00 / $22,408.98 / $35,242.92
| Facility | | $12,833.00 | $22,408.98 | $35,242.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,458.69 / $20,201.71 / $24,494.56
| Facility | | $15,458.69 | $20,201.71 | $24,494.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $27,049.80 / $37,838.68
| Facility | | $3,775.00 | $27,049.80 | $37,838.68 |