- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,755.70 / $22,887.10 / $37,998.00
| Facility | | $15,755.70 | $22,887.10 | $37,998.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,979.43 / $19,088.24 / $38,427.87
| Facility | | $16,979.43 | $19,088.24 | $38,427.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,383.50 / $20,392.00 / $33,963.89
| Facility | | $13,383.50 | $20,392.00 | $33,963.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,727.96 / $24,411.73 / $35,101.08
| Facility | | $19,727.96 | $24,411.73 | $35,101.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,794.78 / $24,507.88 / $59,845.73
| Facility | | $11,794.78 | $24,507.88 | $59,845.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,794.78 / $23,399.24 / $32,886.47
| Facility | | $11,794.78 | $23,399.24 | $32,886.47 |