- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,416.20 / $27,044.10 / $47,317.00
| Facility | | $20,416.20 | $27,044.10 | $47,317.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,871.16 / $11,871.16 / $11,871.16
| Facility | | $11,871.16 | $11,871.16 | $11,871.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $21,715.13 / $42,861.88
| Facility | | $5,939.30 | $21,715.13 | $42,861.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,396.24 / $25,936.35 / $42,245.78
| Facility | | $15,396.24 | $25,936.35 | $42,245.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $30,802.72 / $52,835.00
| Facility | | $3,496.00 | $30,802.72 | $52,835.00 |