- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,746.90 / $21,518.90 / $37,867.10
| Facility | | $12,746.90 | $21,518.90 | $37,867.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,687.39 / $17,520.00 / $22,658.51
| Facility | | $10,687.39 | $17,520.00 | $22,658.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,832.73 / $10,992.85 / $18,074.83
| Facility | | $7,832.73 | $10,992.85 | $18,074.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,595.33 / $19,650.74 / $27,388.85
| Facility | | $11,595.33 | $19,650.74 | $27,388.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,022.00 / $41,022.00 / $48,142.80
| Facility | | $41,022.00 | $41,022.00 | $48,142.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $18,753.56 / $26,787.32
| Facility | | $1,787.00 | $18,753.56 | $26,787.32 |