- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,930.70 / $26,124.00 / $44,107.90
| Facility | | $11,930.70 | $26,124.00 | $44,107.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,223.00 / $38,120.39 / $56,207.84
| Facility | | $21,223.00 | $38,120.39 | $56,207.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,042.85 / $37,240.26 / $54,666.62
| Facility | | $26,042.85 | $37,240.26 | $54,666.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,163.83 / $36,823.76 / $77,220.60
| Facility | | $19,163.83 | $36,823.76 | $77,220.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,042.85 / $40,545.73 / $54,968.00
| Facility | | $26,042.85 | $40,545.73 | $54,968.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,336.85 / $34,291.28 / $51,550.87
| Facility | | $7,336.85 | $34,291.28 | $51,550.87 |