- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,921.80 / $31,545.70 / $43,351.00
| Facility | | $19,921.80 | $31,545.70 | $43,351.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,961.59 / $24,451.86 / $36,489.56
| Facility | | $18,961.59 | $24,451.86 | $36,489.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,022.90 / $28,879.13 / $43,752.51
| Facility | | $18,022.90 | $28,879.13 | $43,752.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $26,210.62 / $44,871.16
| Facility | | $7,516.00 | $26,210.62 | $44,871.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $27,301.53 / $42,463.63
| Facility | | $7,516.00 | $27,301.53 | $42,463.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $35,722.00 / $48,743.56
| Facility | | $10,403.00 | $35,722.00 | $48,743.56 |