- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,547.80 / $23,946.00 / $31,264.90
| Facility | | $11,547.80 | $23,946.00 | $31,264.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,867.61 / $58,557.18
| Facility | | $5,840.42 | $21,867.61 | $58,557.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,530.29 / $22,372.63 / $33,805.31
| Facility | | $13,530.29 | $22,372.63 | $33,805.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,771.43 / $31,771.43 / $31,771.43
| Facility | | $31,771.43 | $31,771.43 | $31,771.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,494.50 / $22,538.41 / $34,804.58
| Facility | | $19,494.50 | $22,538.41 | $34,804.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,867.61 / $58,557.18
| Facility | | $5,840.42 | $21,867.61 | $58,557.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,867.61 / $45,762.96
| Facility | | $5,840.42 | $21,867.61 | $45,762.96 |