- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,499.70 / $25,666.20 / $82,875.00
| Facility | | $16,499.70 | $25,666.20 | $82,875.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,060.34 / $21,060.34 / $35,473.26
| Facility | | $21,060.34 | $21,060.34 | $35,473.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,183.00 / $23,833.65 / $46,129.43
| Facility | | $11,183.00 | $23,833.65 | $46,129.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,884.75 / $26,113.61 / $41,141.00
| Facility | | $19,884.75 | $26,113.61 | $41,141.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,119.01 / $27,423.11 / $71,921.86
| Facility | | $13,119.01 | $27,423.11 | $71,921.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $26,083.06 / $44,032.00
| Facility | | $9,226.00 | $26,083.06 | $44,032.00 |