- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,306.40 / $21,600.10 / $37,792.00
| Facility | | $16,306.40 | $21,600.10 | $37,792.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,830.35 / $16,491.00 / $24,241.82
| Facility | | $10,830.35 | $16,491.00 | $24,241.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $18,994.59 / $37,248.26
| Facility | | $5,939.30 | $18,994.59 | $37,248.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,067.89 / $21,189.00 / $33,741.68
| Facility | | $14,067.89 | $21,189.00 | $33,741.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $22,259.96 / $38,236.48
| Facility | | $3,496.00 | $22,259.96 | $38,236.48 |