- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $19,560.50 / $35,741.30
| Facility | | $3,821.00 | $19,560.50 | $35,741.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,109.59 / $20,570.89 / $28,838.04
| Facility | | $16,109.59 | $20,570.89 | $28,838.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,363.29 / $47,286.79 / $79,979.24
| Facility | | $17,363.29 | $47,286.79 | $79,979.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,794.59 / $28,584.00 / $48,022.36
| Facility | | $20,794.59 | $28,584.00 | $48,022.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,604.43 / $32,019.61 / $46,751.23
| Facility | | $24,604.43 | $32,019.61 | $46,751.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,604.43 / $29,766.49 / $46,751.23
| Facility | | $24,604.43 | $29,766.49 | $46,751.23 |