- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,804.00 / $31,639.30 / $50,692.60
| Facility | | $21,804.00 | $31,639.30 | $50,692.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,013.37 / $28,707.65 / $42,942.37
| Facility | | $18,013.37 | $28,707.65 | $42,942.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,672.73 / $28,997.10 / $51,656.00
| Facility | | $20,672.73 | $28,997.10 | $51,656.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.97 / $294.62 / $482.39
| Facility | | $154.97 | $294.62 | $482.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,769.96 / $31,512.74 / $51,862.62
| Facility | | $22,769.96 | $31,512.74 | $51,862.62 |