- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,310.10 / $23,453.00 / $30,621.30
| Facility | | $11,310.10 | $23,453.00 | $30,621.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,417.44 / $57,351.70
| Facility | | $5,840.42 | $21,417.44 | $57,351.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,251.75 / $21,912.06 / $33,109.37
| Facility | | $13,251.75 | $21,912.06 | $33,109.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,117.37 / $31,117.37 / $31,117.37
| Facility | | $31,117.37 | $31,117.37 | $31,117.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,093.18 / $22,074.42 / $34,088.08
| Facility | | $19,093.18 | $22,074.42 | $34,088.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,417.44 / $57,351.70
| Facility | | $5,840.42 | $21,417.44 | $57,351.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,417.44 / $44,820.86
| Facility | | $5,840.42 | $21,417.44 | $44,820.86 |