- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,534.59 / $27,201.00 / $47,591.40
| Facility | | $20,534.59 | $27,201.00 | $47,591.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,330.00 / $10,330.00 / $31,272.47
| Facility | | $10,330.00 | $10,330.00 | $31,272.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $22,308.06 / $44,514.70
| Facility | | $5,939.30 | $22,308.06 | $44,514.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,485.54 / $26,097.08 / $42,490.80
| Facility | | $15,485.54 | $26,097.08 | $42,490.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $28,031.91 / $42,575.00
| Facility | | $3,496.00 | $28,031.91 | $42,575.00 |