- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,354.00 / $23,954.70 / $39,650.50
| Facility | | $10,354.00 | $23,954.70 | $39,650.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,950.12 / $39,932.28 / $53,800.13
| Facility | | $26,950.12 | $39,932.28 | $53,800.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,098.55 / $31,820.05 / $50,876.91
| Facility | | $17,098.55 | $31,820.05 | $50,876.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,839.72 / $34,279.44 / $71,885.10
| Facility | | $17,839.72 | $34,279.44 | $71,885.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $34,053.08 / $50,889.47
| Facility | | $17,648.00 | $34,053.08 | $50,889.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $22,994.41 / $43,768.10
| Facility | | $5,281.00 | $22,994.41 | $43,768.10 |