- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,162.70 / $23,497.70 / $61,985.10
| Facility | | $18,162.70 | $23,497.70 | $61,985.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,065.70 / $19,957.37 / $29,667.24
| Facility | | $14,065.70 | $19,957.37 | $29,667.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,620.09 / $21,273.77 / $37,243.33
| Facility | | $14,620.09 | $21,273.77 | $37,243.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,088.90 / $25,456.00 / $37,548.00
| Facility | | $20,088.90 | $25,456.00 | $37,548.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,010.58 / $23,879.29 / $62,140.91
| Facility | | $12,010.58 | $23,879.29 | $62,140.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,010.58 / $23,827.34 / $33,488.16
| Facility | | $12,010.58 | $23,827.34 | $33,488.16 |