- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,827.50 / $26,338.60 / $31,803.30
| Facility | | $13,827.50 | $26,338.60 | $31,803.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $23,783.30 / $37,740.82
| Facility | | $12,397.00 | $23,783.30 | $37,740.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,935.20 / $21,895.42 / $25,859.62
| Facility | | $17,935.20 | $21,895.42 | $25,859.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,356.33 / $16,957.50 / $22,688.69
| Facility | | $11,356.33 | $16,957.50 | $22,688.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,940.67 / $22,041.60 / $33,480.58
| Facility | | $12,940.67 | $22,041.60 | $33,480.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,312.12 / $20,096.57 / $24,368.25
| Facility | | $14,312.12 | $20,096.57 | $24,368.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $23,237.94 / $33,434.90
| Facility | | $3,775.00 | $23,237.94 | $33,434.90 |