- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,788.80 / $31,979.20 / $38,614.10
| Facility | | $16,788.80 | $31,979.20 | $38,614.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $28,876.65 / $45,235.37
| Facility | | $12,397.00 | $28,876.65 | $45,235.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,337.71 / $26,016.96 / $30,237.64
| Facility | | $17,337.71 | $26,016.96 | $30,237.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,281.34 / $20,819.04 / $27,194.19
| Facility | | $14,281.34 | $20,819.04 | $27,194.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,963.85 / $26,503.48 / $40,129.14
| Facility | | $14,963.85 | $26,503.48 | $40,129.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,154.21 / $22,739.97 / $31,429.32
| Facility | | $17,154.21 | $22,739.97 | $31,429.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $29,020.36 / $40,595.19
| Facility | | $3,775.00 | $29,020.36 | $40,595.19 |