- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,825.80 / $23,340.30 / $41,072.10
| Facility | | $13,825.80 | $23,340.30 | $41,072.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,606.29 / $20,606.29 / $22,487.22
| Facility | | $20,606.29 | $20,606.29 | $22,487.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,305.45 / $14,340.96 / $23,780.87
| Facility | | $10,305.45 | $14,340.96 | $23,780.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,576.75 / $21,162.37 / $29,528.29
| Facility | | $12,576.75 | $21,162.37 | $29,528.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,543.85 / $44,543.85 / $52,275.99
| Facility | | $44,543.85 | $44,543.85 | $52,275.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $20,340.84 / $29,054.57
| Facility | | $1,787.00 | $20,340.84 | $29,054.57 |