- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,716.61 / $20,954.90 / $55,455.00
| Facility | | $15,716.61 | $20,954.90 | $55,455.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,486.00 / $22,665.15 / $29,978.40
| Facility | | $7,486.00 | $22,665.15 | $29,978.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,147.73 / $19,936.84 / $33,365.56
| Facility | | $13,147.73 | $19,936.84 | $33,365.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,043.91 / $22,545.00 / $33,254.00
| Facility | | $18,043.91 | $22,545.00 | $33,254.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,787.94 / $21,993.00 / $35,933.48
| Facility | | $10,787.94 | $21,993.00 | $35,933.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,787.94 / $21,401.80 / $30,079.17
| Facility | | $10,787.94 | $21,401.80 | $30,079.17 |