- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,603.80 / $31,626.80 / $38,188.60
| Facility | | $16,603.80 | $31,626.80 | $38,188.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $28,558.45 / $46,520.57
| Facility | | $12,397.00 | $28,558.45 | $46,520.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,574.75 / $25,832.09 / $29,429.60
| Facility | | $16,574.75 | $25,832.09 | $29,429.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,151.45 / $20,107.59 / $27,966.82
| Facility | | $12,151.45 | $20,107.59 | $27,966.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,028.20 / $26,793.90 / $41,339.16
| Facility | | $15,028.20 | $26,793.90 | $41,339.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,641.58 / $23,669.40 / $31,600.22
| Facility | | $17,641.58 | $23,669.40 | $31,600.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $27,903.60 / $40,147.87
| Facility | | $3,775.00 | $27,903.60 | $40,147.87 |