- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,823.80 / $30,141.10 / $36,394.60
| Facility | | $15,823.80 | $30,141.10 | $36,394.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $27,216.85 / $45,477.72
| Facility | | $6,916.00 | $27,216.85 | $45,477.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,582.54 / $25,253.02 / $30,062.70
| Facility | | $21,582.54 | $25,253.02 | $30,062.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,706.19 / $20,713.91 / $27,339.89
| Facility | | $13,706.19 | $20,713.91 | $27,339.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,560.33 / $26,271.04 / $40,344.14
| Facility | | $15,560.33 | $26,271.04 | $40,344.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,246.11 / $23,293.10 / $30,109.24
| Facility | | $17,246.11 | $23,293.10 | $30,109.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $24,816.70 / $35,749.01
| Facility | | $3,775.00 | $24,816.70 | $35,749.01 |