- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,635.00 / $24,840.40 / $43,554.60
| Facility | | $16,635.00 | $24,840.40 | $43,554.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,553.34 / $31,553.34 / $31,553.34
| Facility | | $31,553.34 | $31,553.34 | $31,553.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,616.56 / $23,323.63 / $32,374.00
| Facility | | $11,616.56 | $23,323.63 | $32,374.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,730.00 / $21,703.98 / $42,047.00
| Facility | | $15,730.00 | $21,703.98 | $42,047.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,732.11 / $28,543.86 / $35,496.00
| Facility | | $15,732.11 | $28,543.86 | $35,496.00 |