- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,818.80 / $32,036.40 / $38,683.10
| Facility | | $16,818.80 | $32,036.40 | $38,683.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $28,928.25 / $44,574.41
| Facility | | $12,397.00 | $28,928.25 | $44,574.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,972.60 / $25,985.36 / $29,740.22
| Facility | | $21,972.60 | $25,985.36 | $29,740.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,980.22 / $22,674.30 / $31,099.20
| Facility | | $14,980.22 | $22,674.30 | $31,099.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,253.37 / $26,716.20 / $41,219.28
| Facility | | $15,253.37 | $26,716.20 | $41,219.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,903.56 / $24,045.34 / $31,508.58
| Facility | | $16,903.56 | $24,045.34 | $31,508.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $29,072.22 / $40,667.74
| Facility | | $3,775.00 | $29,072.22 | $40,667.74 |