- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,850.80 / $31,533.00 / $51,928.00
| Facility | | $12,850.80 | $31,533.00 | $51,928.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,189.44 / $52,218.70 / $67,711.58
| Facility | | $35,189.44 | $52,218.70 | $67,711.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $41,672.92 / $66,630.60
| Facility | | $17,646.00 | $41,672.92 | $66,630.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,363.67 / $44,893.85 / $94,143.83
| Facility | | $23,363.67 | $44,893.85 | $94,143.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,153.41 / $17,153.41 / $17,464.36
| Facility | | $17,153.41 | $17,153.41 | $17,464.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $44,597.39 / $66,647.05
| Facility | | $17,648.00 | $44,597.39 | $66,647.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,295.00 / $30,664.70 / $60,982.08
| Facility | | $8,295.00 | $30,664.70 | $60,982.08 |