- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,569.40 / $17,902.00 / $34,369.10
| Facility | | $11,569.40 | $17,902.00 | $34,369.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,083.15 / $12,083.15 / $12,083.15
| Facility | | $12,083.15 | $12,083.15 | $12,083.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,605.54 / $31,968.50 / $52,731.47
| Facility | | $21,605.54 | $31,968.50 | $52,731.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,524.21 / $18,002.91 / $25,050.72
| Facility | | $10,524.21 | $18,002.91 | $25,050.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,024.74 / $48,537.00 / $48,537.00
| Facility | | $19,024.74 | $48,537.00 | $48,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,021.20 / $24,312.83
| Facility | | $1,787.00 | $17,021.20 | $24,312.83 |