- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,450.65 / $19,579.00 / $33,045.90
| Facility | | $9,450.65 | $19,579.00 | $33,045.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,512.57 / $33,367.55 / $42,741.78
| Facility | | $22,512.57 | $33,367.55 | $42,741.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $26,519.75 / $42,402.29
| Facility | | $14,648.00 | $26,519.75 | $42,402.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,868.14 / $28,569.48 / $59,911.11
| Facility | | $14,868.14 | $28,569.48 | $59,911.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $28,380.82 / $42,412.75
| Facility | | $17,646.00 | $28,380.82 | $42,412.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $19,351.00 / $36,477.60
| Facility | | $5,281.00 | $19,351.00 | $36,477.60 |