- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,356.00 / $18,390.00 / $27,268.00
| Facility | | $7,356.00 | $18,390.00 | $27,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,681.08 / $29,205.36 / $37,870.37
| Facility | | $19,681.08 | $29,205.36 | $37,870.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $23,031.81 / $36,825.44
| Facility | | $14,648.00 | $23,031.81 | $36,825.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,912.64 / $24,811.96 / $52,031.46
| Facility | | $12,912.64 | $24,811.96 | $52,031.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,263.70 / $9,550.49 / $11,910.87
| Facility | | $9,263.70 | $9,550.49 | $11,910.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $24,648.11 / $36,834.53
| Facility | | $17,646.00 | $24,648.11 | $36,834.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,083.83 / $17,246.83 / $31,679.98
| Facility | | $5,083.83 | $17,246.83 | $31,679.98 |