- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,271.70 / $23,373.50 / $30,517.40
| Facility | | $11,271.70 | $23,373.50 | $30,517.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,069.09 / $57,157.15
| Facility | | $5,840.42 | $21,069.09 | $57,157.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,206.80 / $21,837.72 / $32,997.06
| Facility | | $13,206.80 | $21,837.72 | $32,997.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,011.81 / $31,011.81 / $31,011.81
| Facility | | $31,011.81 | $31,011.81 | $31,011.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,028.41 / $21,999.54 / $33,972.44
| Facility | | $19,028.41 | $21,999.54 | $33,972.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,069.09 / $57,157.15
| Facility | | $5,840.42 | $21,069.09 | $57,157.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $21,069.09 / $49,746.56
| Facility | | $3,775.00 | $21,069.09 | $49,746.56 |