- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,189.40 / $23,954.00 / $42,152.10
| Facility | | $14,189.40 | $23,954.00 | $42,152.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,920.18 / $36,571.83 / $60,324.60
| Facility | | $24,920.18 | $36,571.83 | $60,324.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,907.44 / $21,713.65 / $30,176.22
| Facility | | $12,907.44 | $21,713.65 | $30,176.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,340.62 / $48,537.00 / $52,674.07
| Facility | | $21,340.62 | $48,537.00 | $52,674.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $20,875.68 / $29,818.52
| Facility | | $1,787.00 | $20,875.68 | $29,818.52 |