- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,649.40 / $28,677.60 / $50,175.00
| Facility | | $21,649.40 | $28,677.60 | $50,175.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,910.41 / $20,471.63 / $24,779.32
| Facility | | $16,910.41 | $20,471.63 | $24,779.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $24,616.30 / $54,037.44
| Facility | | $5,939.30 | $24,616.30 | $54,037.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,326.20 / $27,513.81 / $44,797.50
| Facility | | $16,326.20 | $27,513.81 | $44,797.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $29,553.68 / $45,139.59
| Facility | | $3,496.00 | $29,553.68 | $45,139.59 |