- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,173.20 / $28,985.90 / $51,044.10
| Facility | | $18,173.20 | $28,985.90 | $51,044.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,916.59 / $26,031.60 / $37,842.49
| Facility | | $9,916.59 | $26,031.60 | $37,842.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,804.07 / $22,538.05 / $37,756.50
| Facility | | $16,804.07 | $22,538.05 | $37,756.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,595.26 / $21,276.68 / $26,183.74
| Facility | | $14,595.26 | $21,276.68 | $26,183.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,366.03 / $23,426.95 / $35,415.29
| Facility | | $7,366.03 | $23,426.95 | $35,415.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,895.02 / $25,221.62 / $34,256.86
| Facility | | $17,895.02 | $25,221.62 | $34,256.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $18,155.65 / $47,295.97
| Facility | | $3,775.00 | $18,155.65 | $47,295.97 |