- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,734.80 / $32,736.60 / $43,930.00
| Facility | | $19,734.80 | $32,736.60 | $43,930.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,975.45 / $26,975.45 / $26,975.45
| Facility | | $26,975.45 | $26,975.45 | $26,975.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,473.32 / $27,806.97 / $44,492.22
| Facility | | $16,473.32 | $27,806.97 | $44,492.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,204.90 / $26,358.00 / $60,449.44
| Facility | | $16,204.90 | $26,358.00 | $60,449.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,239.58 / $25,964.39 / $37,235.07
| Facility | | $19,239.58 | $25,964.39 | $37,235.07 |