- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,155.10 / $27,576.00 / $44,822.70
| Facility | | $16,155.10 | $27,576.00 | $44,822.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,876.92 / $29,876.92 / $29,876.92
| Facility | | $29,876.92 | $29,876.92 | $29,876.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,852.86 / $21,910.54 / $34,565.99
| Facility | | $13,852.86 | $21,910.54 | $34,565.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,047.36 / $15,799.46 / $34,861.04
| Facility | | $7,047.36 | $15,799.46 | $34,861.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,292.00 / $22,599.87 / $31,663.11
| Facility | | $6,292.00 | $22,599.87 | $31,663.11 |