- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,516.80 / $23,028.00 / $38,880.40
| Facility | | $10,516.80 | $23,028.00 | $38,880.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,534.00 / $29,303.12 / $53,311.90
| Facility | | $18,534.00 | $29,303.12 | $53,311.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,956.41 / $32,826.76 / $48,187.86
| Facility | | $22,956.41 | $32,826.76 | $48,187.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,892.65 / $32,459.63 / $68,068.87
| Facility | | $16,892.65 | $32,459.63 | $68,068.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,466.04 / $12,466.04 / $12,742.14
| Facility | | $12,466.04 | $12,466.04 | $12,742.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,956.41 / $35,740.49 / $48,453.52
| Facility | | $22,956.41 | $35,740.49 | $48,453.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,650.79 / $30,227.28 / $45,441.37
| Facility | | $6,650.79 | $30,227.28 | $45,441.37 |