- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,053.10 / $23,724.00 / $41,747.40
| Facility | | $14,053.10 | $23,724.00 | $41,747.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,367.44 / $7,600.06 / $12,266.12
| Facility | | $5,367.44 | $7,600.06 | $12,266.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,783.52 / $21,505.19 / $29,933.43
| Facility | | $12,783.52 | $21,505.19 | $29,933.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,054.35 / $46,054.35 / $54,048.69
| Facility | | $46,054.35 | $46,054.35 | $54,048.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $20,675.27 / $29,532.26
| Facility | | $1,787.00 | $20,675.27 | $29,532.26 |