- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,354.00 / $23,381.50 / $38,701.69
| Facility | | $10,354.00 | $23,381.50 | $38,701.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,965.92 / $40,015.57 / $51,887.88
| Facility | | $26,965.92 | $40,015.57 | $51,887.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,689.40 / $31,058.63 / $49,659.48
| Facility | | $16,689.40 | $31,058.63 | $49,659.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,412.83 / $33,459.18 / $70,164.96
| Facility | | $17,412.83 | $33,459.18 | $70,164.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $33,238.23 / $49,671.74
| Facility | | $17,648.00 | $33,238.23 | $49,671.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $22,444.18 / $42,720.78
| Facility | | $5,281.00 | $22,444.18 | $42,720.78 |