- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,233.80 / $25,207.60 / $30,437.60
| Facility | | $13,233.80 | $25,207.60 | $30,437.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $22,762.05 / $39,071.32
| Facility | | $6,916.00 | $22,762.05 | $39,071.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,834.16 / $21,202.06 / $25,756.68
| Facility | | $18,834.16 | $21,202.06 | $25,756.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,091.88 / $17,166.68 / $24,302.37
| Facility | | $12,091.88 | $17,166.68 | $24,302.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,849.10 / $22,984.06 / $34,132.60
| Facility | | $13,849.10 | $22,984.06 | $34,132.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,330.03 / $20,509.77 / $26,693.87
| Facility | | $15,330.03 | $20,509.77 | $26,693.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $20,754.75 / $29,897.69
| Facility | | $3,775.00 | $20,754.75 | $29,897.69 |