- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,421.40 / $26,191.80 / $46,123.80
| Facility | | $16,421.40 | $26,191.80 | $46,123.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,855.96 / $19,943.50 / $29,224.67
| Facility | | $6,855.96 | $19,943.50 | $29,224.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,184.26 / $20,365.52 / $34,117.01
| Facility | | $15,184.26 | $20,365.52 | $34,117.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,100.62 / $15,325.20 / $18,349.52
| Facility | | $10,100.62 | $15,325.20 | $18,349.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $17,503.81 / $27,355.59
| Facility | | $6,409.00 | $17,503.81 | $27,355.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,822.53 / $19,361.70 / $26,323.29
| Facility | | $13,822.53 | $19,361.70 | $26,323.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,405.56 / $44,825.30
| Facility | | $3,775.00 | $16,405.56 | $44,825.30 |