- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,509.40 / $23,866.40 / $31,161.00
| Facility | | $11,509.40 | $23,866.40 | $31,161.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,513.45 / $58,362.63
| Facility | | $5,840.42 | $21,513.45 | $58,362.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,485.33 / $22,298.29 / $33,692.99
| Facility | | $13,485.33 | $22,298.29 | $33,692.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,665.87 / $31,665.87 / $31,665.87
| Facility | | $31,665.87 | $31,665.87 | $31,665.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,429.73 / $22,463.52 / $34,688.94
| Facility | | $19,429.73 | $22,463.52 | $34,688.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,513.45 / $58,362.63
| Facility | | $5,840.42 | $21,513.45 | $58,362.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,949.75 / $45,610.91
| Facility | | $5,840.42 | $16,949.75 | $45,610.91 |