- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,386.80 / $23,612.20 / $30,829.00
| Facility | | $11,386.80 | $23,612.20 | $30,829.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,284.24 / $57,740.81
| Facility | | $5,840.42 | $21,284.24 | $57,740.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,341.66 / $22,060.72 / $33,334.01
| Facility | | $13,341.66 | $22,060.72 | $33,334.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,328.49 / $31,328.49 / $31,328.49
| Facility | | $31,328.49 | $31,328.49 | $31,328.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,222.72 / $22,224.19 / $34,319.37
| Facility | | $19,222.72 | $22,224.19 | $34,319.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,284.24 / $57,740.81
| Facility | | $5,840.42 | $21,284.24 | $57,740.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,562.75 / $45,124.96
| Facility | | $5,840.42 | $21,562.75 | $45,124.96 |