- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,529.90 / $34,055.60 / $45,700.00
| Facility | | $20,529.90 | $34,055.60 | $45,700.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,263.86 / $23,993.70 / $28,482.16
| Facility | | $20,263.86 | $23,993.70 | $28,482.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,335.92 / $28,389.37 / $45,424.09
| Facility | | $16,335.92 | $28,389.37 | $45,424.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,857.82 / $27,420.00 / $62,885.03
| Facility | | $16,857.82 | $27,420.00 | $62,885.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,014.77 / $26,615.68 / $38,263.69
| Facility | | $20,014.77 | $26,615.68 | $38,263.69 |