- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,347.70 / $27,037.00 / $45,649.30
| Facility | | $12,347.70 | $27,037.00 | $45,649.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,265.64 / $41,793.15 / $59,836.64
| Facility | | $28,265.64 | $41,793.15 | $59,836.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,952.98 / $38,541.72 / $56,577.08
| Facility | | $26,952.98 | $38,541.72 | $56,577.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,833.56 / $38,110.66 / $79,919.25
| Facility | | $19,833.56 | $38,110.66 | $79,919.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,891.15 / $16,891.15 / $16,891.15
| Facility | | $16,891.15 | $16,891.15 | $16,891.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,952.98 / $41,962.69 / $56,888.99
| Facility | | $26,952.98 | $41,962.69 | $56,888.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,175.42 / $33,792.00 / $53,287.26
| Facility | | $12,175.42 | $33,792.00 | $53,287.26 |