- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,738.20 / $26,697.10 / $47,013.60
| Facility | | $16,738.20 | $26,697.10 | $47,013.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $21,973.48 / $31,155.98
| Facility | | $6,746.00 | $21,973.48 | $31,155.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,477.21 / $20,758.43 / $34,775.22
| Facility | | $15,477.21 | $20,758.43 | $34,775.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,797.43 / $16,988.09 / $21,309.19
| Facility | | $11,797.43 | $16,988.09 | $21,309.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $18,858.14 / $30,937.50
| Facility | | $6,409.00 | $18,858.14 | $30,937.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,052.02 / $22,005.99 / $30,170.58
| Facility | | $16,052.02 | $22,005.99 | $30,170.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,722.07 / $43,561.44
| Facility | | $3,775.00 | $16,722.07 | $43,561.44 |