- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,408.80 / $31,255.40 / $37,740.10
| Facility | | $16,408.80 | $31,255.40 | $37,740.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,397.00 / $28,223.05 / $46,571.98
| Facility | | $12,397.00 | $28,223.05 | $46,571.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,917.89 / $25,922.38 / $29,675.82
| Facility | | $22,917.89 | $25,922.38 | $29,675.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,115.63 / $22,621.50 / $30,162.00
| Facility | | $16,115.63 | $22,621.50 | $30,162.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,929.42 / $28,223.05 / $44,216.28
| Facility | | $15,929.42 | $28,223.05 | $44,216.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,661.08 / $24,799.07 / $33,799.51
| Facility | | $17,661.08 | $24,799.07 | $33,799.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $27,575.89 / $39,676.36
| Facility | | $3,775.00 | $27,575.89 | $39,676.36 |