- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,146.00 / $23,198.90 / $37,353.10
| Facility | | $10,146.00 | $23,198.90 | $37,353.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,540.82 / $26,540.82 / $26,540.82
| Facility | | $26,540.82 | $26,540.82 | $26,540.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $16,858.36 / $31,930.34
| Facility | | $1,474.01 | $16,858.36 | $31,930.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,464.00 / $22,975.13 / $34,361.42
| Facility | | $16,464.00 | $22,975.13 | $34,361.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,678.93 / $24,821.09 / $43,819.00
| Facility | | $14,678.93 | $24,821.09 | $43,819.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,678.93 / $26,042.00 / $43,819.00
| Facility | | $14,678.93 | $26,042.00 | $43,819.00 |