- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,826.10 / $38,002.10 / $66,921.80
| Facility | | $23,826.10 | $38,002.10 | $66,921.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,743.79 / $30,596.41 / $44,478.42
| Facility | | $12,743.79 | $30,596.41 | $44,478.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,031.11 / $29,548.69 / $49,500.96
| Facility | | $22,031.11 | $29,548.69 | $49,500.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,852.11 / $24,604.80 / $28,438.51
| Facility | | $15,852.11 | $24,604.80 | $28,438.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,531.48 / $27,535.02 / $41,625.58
| Facility | | $7,531.48 | $27,535.02 | $41,625.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,033.03 / $29,614.33 / $40,223.19
| Facility | | $21,033.03 | $29,614.33 | $40,223.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $23,803.11 / $65,037.81
| Facility | | $3,775.00 | $23,803.11 | $65,037.81 |