- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,980.53 / $16,164.00 / $26,733.80
| Facility | | $7,980.53 | $16,164.00 | $26,733.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,530.84 / $26,014.57 / $33,732.89
| Facility | | $17,530.84 | $26,014.57 | $33,732.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,647.00 / $21,454.26 / $34,303.10
| Facility | | $14,647.00 | $21,454.26 | $34,303.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,028.20 / $23,112.47 / $48,467.59
| Facility | | $12,028.20 | $23,112.47 | $48,467.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,958.54 / $8,958.54 / $8,958.54
| Facility | | $8,958.54 | $8,958.54 | $8,958.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,968.03 / $22,959.85 / $34,311.56
| Facility | | $16,968.03 | $22,959.85 | $34,311.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,763.00 / $29,510.07
| Facility | | $4,870.00 | $16,763.00 | $29,510.07 |