- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,536.00 / $30,784.90 / $53,977.50
| Facility | | $14,536.00 | $30,784.90 | $53,977.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,534.32 / $22,534.32 / $45,660.07
| Facility | | $22,534.32 | $22,534.32 | $45,660.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,982.28 / $25,448.18 / $35,839.47
| Facility | | $12,982.28 | $25,448.18 | $35,839.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,077.47 / $30,784.86 / $78,285.00
| Facility | | $20,077.47 | $30,784.86 | $78,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,477.72 / $30,462.14 / $46,777.00
| Facility | | $16,477.72 | $30,462.14 | $46,777.00 |