- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,767.00 / $31,252.00 / $41,075.90
| Facility | | $5,767.00 | $31,252.00 | $41,075.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,281.27 / $21,281.27 / $27,918.01
| Facility | | $21,281.27 | $21,281.27 | $27,918.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,690.63 / $37,588.31 / $63,062.13
| Facility | | $13,690.63 | $37,588.31 | $63,062.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,424.29 / $29,897.95 / $52,541.31
| Facility | | $21,424.29 | $29,897.95 | $52,541.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,919.73 / $35,032.68 / $51,150.57
| Facility | | $26,919.73 | $35,032.68 | $51,150.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,919.73 / $32,567.55 / $51,150.57
| Facility | | $26,919.73 | $32,567.55 | $51,150.57 |