- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,385.30 / $40,489.00 / $71,301.30
| Facility | | $25,385.30 | $40,489.00 | $71,301.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,060.24 / $31,945.24 / $46,812.22
| Facility | | $12,060.24 | $31,945.24 | $46,812.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,472.86 / $31,482.40 / $52,740.37
| Facility | | $23,472.86 | $31,482.40 | $52,740.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,808.58 / $26,953.43 / $28,675.50
| Facility | | $15,808.58 | $26,953.43 | $28,675.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,806.18 / $29,449.12 / $42,939.97
| Facility | | $6,806.18 | $29,449.12 | $42,939.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,552.18 / $31,925.82 / $43,445.53
| Facility | | $21,552.18 | $31,925.82 | $43,445.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $25,360.82 / $66,065.63
| Facility | | $3,775.00 | $25,360.82 | $66,065.63 |