- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,627.50 / $27,862.50 / $33,643.30
| Facility | | $14,627.50 | $27,862.50 | $33,643.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $25,159.30 / $44,360.19
| Facility | | $6,916.00 | $25,159.30 | $44,360.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,709.68 / $23,756.40 / $28,566.38
| Facility | | $20,709.68 | $23,756.40 | $28,566.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,595.26 / $21,276.68 / $28,281.00
| Facility | | $14,595.26 | $21,276.68 | $28,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,866.04 / $26,975.12 / $41,129.19
| Facility | | $15,866.04 | $26,975.12 | $41,129.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,581.71 / $23,999.01 / $30,941.41
| Facility | | $17,581.71 | $23,999.01 | $30,941.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $22,940.60 / $33,046.44
| Facility | | $3,775.00 | $22,940.60 | $33,046.44 |