- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,678.50 / $30,958.60 / $50,982.00
| Facility | | $10,678.50 | $30,958.60 | $50,982.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,906.23 / $54,038.97 / $69,462.74
| Facility | | $34,906.23 | $54,038.97 | $69,462.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $40,913.78 / $65,416.82
| Facility | | $17,646.00 | $40,913.78 | $65,416.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,938.06 / $44,076.04 / $92,428.84
| Facility | | $22,938.06 | $44,076.04 | $92,428.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,648.00 / $43,784.97 / $65,432.97
| Facility | | $17,648.00 | $43,784.97 | $65,432.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $29,296.68 / $56,276.41
| Facility | | $5,281.00 | $29,296.68 | $56,276.41 |