- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,819.20 / $36,194.40 / $48,570.00
| Facility | | $21,819.20 | $36,194.40 | $48,570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,531.46 / $18,531.46 / $24,292.67
| Facility | | $18,531.46 | $18,531.46 | $24,292.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,810.86 / $28,622.02 / $45,796.33
| Facility | | $16,810.86 | $28,622.02 | $45,796.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,916.50 / $29,142.00 / $66,834.25
| Facility | | $17,916.50 | $29,142.00 | $66,834.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,145.44 / $28,706.81 / $41,385.53
| Facility | | $21,145.44 | $28,706.81 | $41,385.53 |