- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,054.76 / $22,350.20 / $39,953.00
| Facility | | $16,054.76 | $22,350.20 | $39,953.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,486.43 / $16,486.43 / $20,205.75
| Facility | | $16,486.43 | $16,486.43 | $20,205.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,964.12 / $19,421.00 / $32,899.60
| Facility | | $12,964.12 | $19,421.00 | $32,899.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,245.37 / $23,814.56 / $34,242.43
| Facility | | $19,245.37 | $23,814.56 | $34,242.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,963.75 / $23,908.36 / $57,970.40
| Facility | | $11,963.75 | $23,908.36 | $57,970.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,963.75 / $20,985.37 / $31,672.35
| Facility | | $11,963.75 | $20,985.37 | $31,672.35 |