- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,638.30 / $29,863.00 / $50,420.70
| Facility | | $13,638.30 | $29,863.00 | $50,420.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,707.47 / $47,853.98 / $61,298.00
| Facility | | $31,707.47 | $47,853.98 | $61,298.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,770.21 / $42,570.24 / $62,490.73
| Facility | | $29,770.21 | $42,570.24 | $62,490.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,906.63 / $42,094.13 / $88,272.71
| Facility | | $21,906.63 | $42,094.13 | $88,272.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,770.21 / $46,348.79 / $62,835.24
| Facility | | $29,770.21 | $46,348.79 | $62,835.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,624.85 / $38,193.06 / $58,298.28
| Facility | | $8,624.85 | $38,193.06 | $58,298.28 |