- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,019.50 / $28,740.60 / $50,612.30
| Facility | | $18,019.50 | $28,740.60 | $50,612.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,189.33 / $24,636.56 / $35,814.50
| Facility | | $9,189.33 | $24,636.56 | $35,814.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,661.91 / $22,347.38 / $37,437.08
| Facility | | $16,661.91 | $22,347.38 | $37,437.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,367.99 / $18,456.90 / $22,482.71
| Facility | | $12,367.99 | $18,456.90 | $22,482.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $21,803.38 / $33,517.37
| Facility | | $6,746.00 | $21,803.38 | $33,517.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,936.02 / $23,722.88 / $32,252.55
| Facility | | $16,936.02 | $23,722.88 | $32,252.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,002.05 / $46,895.85
| Facility | | $3,775.00 | $18,002.05 | $46,895.85 |