- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,321.20 / $23,599.40 / $37,998.00
| Facility | | $10,321.20 | $23,599.40 | $37,998.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,391.76 / $15,391.76 / $15,391.76
| Facility | | $15,391.76 | $15,391.76 | $15,391.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $12,046.68 / $33,063.86
| Facility | | $1,474.01 | $12,046.68 | $33,063.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,082.91 / $24,674.67 / $34,954.62
| Facility | | $17,082.91 | $24,674.67 | $34,954.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,932.34 / $20,695.32 / $43,462.73
| Facility | | $14,932.34 | $20,695.32 | $43,462.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,019.92 / $20,695.32 / $44,023.92
| Facility | | $14,019.92 | $20,695.32 | $44,023.92 |