- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,682.30 / $19,721.59 / $34,704.30
| Facility | | $11,682.30 | $19,721.59 | $34,704.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,327.45 / $23,327.45 / $23,327.45
| Facility | | $23,327.45 | $23,327.45 | $23,327.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,998.21 / $14,762.57 / $24,202.82
| Facility | | $9,998.21 | $14,762.57 | $24,202.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,626.84 / $18,159.00 / $25,101.21
| Facility | | $10,626.84 | $18,159.00 | $25,101.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,910.15 / $35,910.15 / $42,143.61
| Facility | | $35,910.15 | $35,910.15 | $42,143.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,187.18 / $24,549.92
| Facility | | $1,787.00 | $17,187.18 | $24,549.92 |