- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,962.09 / $35,781.50 / $58,160.00
| Facility | | $20,962.09 | $35,781.50 | $58,160.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,762.00 / $27,495.12 / $29,505.18
| Facility | | $15,762.00 | $27,495.12 | $29,505.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,974.90 / $28,430.21 / $44,851.40
| Facility | | $17,974.90 | $28,430.21 | $44,851.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,382.00 / $19,504.05 / $45,234.25
| Facility | | $8,382.00 | $19,504.05 | $45,234.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,842.00 / $29,693.77 / $40,844.39
| Facility | | $6,842.00 | $29,693.77 | $40,844.39 |