- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,218.80 / $27,083.90 / $32,703.10
| Facility | | $14,218.80 | $27,083.90 | $32,703.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $24,456.25 / $37,630.66
| Facility | | $12,397.00 | $24,456.25 | $37,630.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,494.20 / $22,439.98 / $26,438.10
| Facility | | $17,494.20 | $22,439.98 | $26,438.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,148.02 / $18,138.96 / $25,740.00
| Facility | | $12,148.02 | $18,138.96 | $25,740.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,904.63 / $22,289.40 / $34,702.65
| Facility | | $12,904.63 | $22,289.40 | $34,702.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,270.34 / $19,901.70 / $28,501.86
| Facility | | $14,270.34 | $19,901.70 | $28,501.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $23,895.46 / $34,380.94
| Facility | | $3,775.00 | $23,895.46 | $34,380.94 |