- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,861.20 / $26,309.00 / $46,030.70
| Facility | | $19,861.20 | $26,309.00 | $46,030.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,621.43 / $31,621.43 / $31,621.43
| Facility | | $31,621.43 | $31,621.43 | $31,621.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $22,896.81 / $45,194.31
| Facility | | $5,939.30 | $22,896.81 | $45,194.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,930.00 / $25,241.26 / $41,097.37
| Facility | | $15,930.00 | $25,241.26 | $41,097.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $29,965.38 / $46,572.04
| Facility | | $3,496.00 | $29,965.38 | $46,572.04 |