- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,418.80 / $27,297.10 / $40,695.00
| Facility | | $16,418.80 | $27,297.10 | $40,695.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,805.32 / $26,805.32 / $26,805.32
| Facility | | $26,805.32 | $26,805.32 | $26,805.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,137.06 / $22,652.63 / $34,319.22
| Facility | | $14,137.06 | $22,652.63 | $34,319.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,422.14 / $22,943.97 / $36,980.99
| Facility | | $15,422.14 | $22,943.97 | $36,980.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,036.11 / $22,500.81 / $34,996.80
| Facility | | $14,036.11 | $22,500.81 | $34,996.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $27,798.66 / $40,573.68
| Facility | | $10,403.00 | $27,798.66 | $40,573.68 |