- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,441.59 / $26,224.00 / $46,180.50
| Facility | | $16,441.59 | $26,224.00 | $46,180.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,820.00 / $21,731.77 / $31,445.16
| Facility | | $10,820.00 | $21,731.77 | $31,445.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,202.93 / $20,390.56 / $34,158.96
| Facility | | $15,202.93 | $20,390.56 | $34,158.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,091.88 / $17,127.50 / $21,692.69
| Facility | | $12,091.88 | $17,127.50 | $21,692.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $19,882.24 / $28,844.05
| Facility | | $6,746.00 | $19,882.24 | $28,844.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,477.24 / $21,458.36 / $29,555.20
| Facility | | $14,477.24 | $21,458.36 | $29,555.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $16,425.73 / $42,789.48
| Facility | | $3,775.00 | $16,425.73 | $42,789.48 |