- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,925.03 / $18,563.00 / $31,207.90
| Facility | | $8,925.03 | $18,563.00 | $31,207.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,749.41 / $30,790.71 / $39,926.07
| Facility | | $20,749.41 | $30,790.71 | $39,926.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $25,044.78 / $40,043.97
| Facility | | $14,648.00 | $25,044.78 | $40,043.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,041.21 / $26,980.52 / $56,579.00
| Facility | | $14,041.21 | $26,980.52 | $56,579.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $26,802.35 / $40,053.86
| Facility | | $17,646.00 | $26,802.35 | $40,053.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $18,429.02 / $34,448.80
| Facility | | $5,281.00 | $18,429.02 | $34,448.80 |