- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,387.50 / $35,024.50 / $42,291.30
| Facility | | $18,387.50 | $35,024.50 | $42,291.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $31,626.50 / $52,116.70
| Facility | | $12,397.00 | $31,626.50 | $52,116.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,714.40 / $28,939.53 / $32,006.62
| Facility | | $20,714.40 | $28,939.53 | $32,006.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,345.92 / $22,326.50 / $31,331.05
| Facility | | $16,345.92 | $22,326.50 | $31,331.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,805.91 / $29,768.90 / $46,233.70
| Facility | | $17,805.91 | $29,768.90 | $46,233.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,763.75 / $27,235.13 / $32,551.27
| Facility | | $19,763.75 | $27,235.13 | $32,551.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $30,901.30 / $44,460.98
| Facility | | $3,775.00 | $30,901.30 | $44,460.98 |