- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $23,577.40 / $40,146.80
| Facility | | $3,182.00 | $23,577.40 | $40,146.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,929.38 / $24,456.02 / $32,002.15
| Facility | | $23,929.38 | $24,456.02 | $32,002.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $13,641.09 / $36,578.12
| Facility | | $1,474.01 | $13,641.09 | $36,578.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,940.39 / $26,356.66 / $39,418.82
| Facility | | $17,940.39 | $26,356.66 | $39,418.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,810.46 / $22,769.71 / $49,013.52
| Facility | | $15,810.46 | $22,769.71 | $49,013.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,810.46 / $22,694.48 / $42,076.39
| Facility | | $15,810.46 | $22,694.48 | $42,076.39 |