- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,483.00 / $23,574.40 / $47,919.80
| Facility | | $17,483.00 | $23,574.40 | $47,919.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,075.63 / $26,835.79 / $28,264.91
| Facility | | $26,075.63 | $26,835.79 | $28,264.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,320.45 / $21,711.55 / $24,821.91
| Facility | | $17,320.45 | $21,711.55 | $24,821.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,603.16 / $25,849.13 / $33,617.90
| Facility | | $14,603.16 | $25,849.13 | $33,617.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,986.97 / $32,202.95 / $32,504.65
| Facility | | $29,986.97 | $32,202.95 | $32,504.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $22,428.11 / $33,020.50
| Facility | | $1,518.00 | $22,428.11 | $33,020.50 |