- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,912.70 / $23,487.00 / $41,330.30
| Facility | | $13,912.70 | $23,487.00 | $41,330.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,199.24 / $12,073.82 / $20,011.45
| Facility | | $8,199.24 | $12,073.82 | $20,011.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,655.81 / $21,290.34 / $29,683.20
| Facility | | $12,655.81 | $21,290.34 | $29,683.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,078.20 / $46,078.20 / $54,076.68
| Facility | | $46,078.20 | $46,078.20 | $54,076.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $20,468.72 / $29,237.22
| Facility | | $1,787.00 | $20,468.72 | $29,237.22 |