- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,767.08 / $18,312.00 / $52,764.60
| Facility | | $7,767.08 | $18,312.00 | $52,764.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,204.83 / $29,937.72 / $40,334.62
| Facility | | $20,204.83 | $29,937.72 | $40,334.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $23,499.15 / $37,572.66
| Facility | | $14,648.00 | $23,499.15 | $37,572.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,174.65 / $25,315.42 / $53,087.23
| Facility | | $13,174.65 | $25,315.42 | $53,087.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $25,148.24 / $37,581.94
| Facility | | $17,646.00 | $25,148.24 | $37,581.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,186.99 / $17,421.55 / $32,322.80
| Facility | | $5,186.99 | $17,421.55 | $32,322.80 |