- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,354.00 / $23,057.70 / $39,221.50
| Facility | | $10,354.00 | $23,057.70 | $39,221.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,169.00 / $36,264.83 / $46,453.02
| Facility | | $24,169.00 | $36,264.83 | $46,453.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,913.58 / $31,475.82 / $50,326.52
| Facility | | $16,913.58 | $31,475.82 | $50,326.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.73 / $33,908.61 / $71,107.42
| Facility | | $17,646.73 | $33,908.61 | $71,107.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $33,684.69 / $50,338.94
| Facility | | $17,648.00 | $33,684.69 | $50,338.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $22,745.65 / $43,294.61
| Facility | | $5,281.00 | $22,745.65 | $43,294.61 |