- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,120.00 / $9,388.00 / $29,484.60
| Facility | | $2,120.00 | $9,388.00 | $29,484.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,176.55 / $26,642.70 / $44,279.02
| Facility | | $19,176.55 | $26,642.70 | $44,279.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,758.46 / $23,871.69 / $46,056.05
| Facility | | $14,758.46 | $23,871.69 | $46,056.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,401.22 / $33,201.17 / $51,018.66
| Facility | | $18,401.22 | $33,201.17 | $51,018.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,044.80 / $44,049.26 / $56,874.98
| Facility | | $24,044.80 | $44,049.26 | $56,874.98 |