- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,171.00 / $23,294.20 / $40,874.60
| Facility | | $3,171.00 | $23,294.20 | $40,874.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,581.00 / $44,902.62 / $58,978.73
| Facility | | $17,581.00 | $44,902.62 | $58,978.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,088.00 / $40,856.47 / $60,139.12
| Facility | | $26,088.00 | $40,856.47 | $60,139.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.53 / $25,207.00 / $43,248.24
| Facility | | $8,148.53 | $25,207.00 | $43,248.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,575.00 / $36,582.64 / $60,124.28
| Facility | | $10,575.00 | $36,582.64 | $60,124.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,994.00 / $22,233.00 / $53,077.61
| Facility | | $5,994.00 | $22,233.00 | $53,077.61 |