- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,631.90 / $19,966.00 / $43,768.20
| Facility | | $12,631.90 | $19,966.00 | $43,768.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,455.13 / $21,426.75 / $25,222.43
| Facility | | $4,455.13 | $21,426.75 | $25,222.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,943.80 / $23,534.62 / $39,026.23
| Facility | | $15,943.80 | $23,534.62 | $39,026.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,402.33 / $21,938.77 / $31,145.89
| Facility | | $13,402.33 | $21,938.77 | $31,145.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,956.00 / $23,846.34 / $33,449.00
| Facility | | $2,956.00 | $23,846.34 | $33,449.00 |