- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,652.20 / $18,451.09 / $29,952.00
| Facility | | $12,652.20 | $18,451.09 | $29,952.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,970.06 / $24,970.06 / $30,353.75
| Facility | | $24,970.06 | $24,970.06 | $30,353.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,732.20 / $35,160.51 / $45,077.58
| Facility | | $24,732.20 | $35,160.51 | $45,077.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,856.66 / $28,723.95 / $36,330.60
| Facility | | $14,856.66 | $28,723.95 | $36,330.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,200.50 / $19,842.90 / $31,729.60
| Facility | | $13,200.50 | $19,842.90 | $31,729.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,437.79 / $26,398.82 / $40,107.47
| Facility | | $15,437.79 | $26,398.82 | $40,107.47 |