- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,423.81 / $25,916.00 / $57,009.00
| Facility | | $16,423.81 | $25,916.00 | $57,009.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,854.48 / $22,252.90 / $38,433.72
| Facility | | $14,854.48 | $22,252.90 | $38,433.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,267.00 / $27,614.04 / $39,705.62
| Facility | | $22,267.00 | $27,614.04 | $39,705.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,342.02 / $27,132.39 / $48,722.00
| Facility | | $13,342.02 | $27,132.39 | $48,722.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,342.02 / $26,468.73 / $37,200.50
| Facility | | $13,342.02 | $26,468.73 | $37,200.50 |