- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,882.70 / $23,585.80 / $39,158.00
| Facility | | $14,882.70 | $23,585.80 | $39,158.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,891.00 / $18,714.23 / $34,229.44
| Facility | | $10,891.00 | $18,714.23 | $34,229.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,619.50 / $24,085.23 / $36,172.62
| Facility | | $18,619.50 | $24,085.23 | $36,172.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,898.00 / $22,801.20 / $54,664.47
| Facility | | $9,898.00 | $22,801.20 | $54,664.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,427.00 / $22,999.37 / $34,707.32
| Facility | | $9,427.00 | $22,999.37 | $34,707.32 |