- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,017.90 / $27,841.10 / $48,711.30
| Facility | | $21,017.90 | $27,841.10 | $48,711.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,330.00 / $19,685.18 / $26,747.53
| Facility | | $10,330.00 | $19,685.18 | $26,747.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $25,022.94 / $48,412.96
| Facility | | $5,939.30 | $25,022.94 | $48,412.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,849.94 / $26,711.20 / $43,490.70
| Facility | | $15,849.94 | $26,711.20 | $43,490.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $23,940.09 / $43,822.81
| Facility | | $3,496.00 | $23,940.09 | $43,822.81 |