- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,756.85 / $20,022.59 / $32,238.90
| Facility | | $8,756.85 | $20,022.59 | $32,238.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,972.47 / $24,972.47 / $24,972.47
| Facility | | $24,972.47 | $24,972.47 | $24,972.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $8,858.51 / $30,365.81
| Facility | | $1,474.01 | $8,858.51 | $30,365.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,493.75 / $20,934.86 / $29,656.75
| Facility | | $14,493.75 | $20,934.86 | $29,656.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,669.13 / $17,558.65 / $36,875.32
| Facility | | $12,669.13 | $17,558.65 | $36,875.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,895.00 / $17,558.65 / $37,351.44
| Facility | | $11,895.00 | $17,558.65 | $37,351.44 |