- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,511.90 / $23,511.90 / $27,866.30
| Facility | | $23,511.90 | $23,511.90 | $27,866.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,721.79 / $28,834.29 / $43,134.35
| Facility | | $17,721.79 | $28,834.29 | $43,134.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,229.84 / $23,801.00 / $40,494.65
| Facility | | $19,229.84 | $23,801.00 | $40,494.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,204.61 / $27,604.84 / $45,185.15
| Facility | | $17,204.61 | $27,604.84 | $45,185.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.70 / $16,453.28 / $23,507.78
| Facility | | $260.70 | $16,453.28 | $23,507.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,578.00 / $27,272.41 / $32,051.92
| Facility | | $19,578.00 | $27,272.41 | $32,051.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,669.14 / $29,090.01 / $36,670.33
| Facility | | $17,669.14 | $29,090.01 | $36,670.33 |