- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,210.00 / $28,504.60 / $47,275.80
| Facility | | $18,210.00 | $28,504.60 | $47,275.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,523.48 / $25,037.81 / $35,930.90
| Facility | | $7,523.48 | $25,037.81 | $35,930.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,157.05 / $25,205.70 / $43,413.77
| Facility | | $14,157.05 | $25,205.70 | $43,413.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,081.00 / $29,078.32 / $43,671.54
| Facility | | $12,081.00 | $29,078.32 | $43,671.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,258.13 / $31,370.71 / $73,626.14
| Facility | | $15,258.13 | $31,370.71 | $73,626.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,674.65 / $29,842.45 / $40,916.19
| Facility | | $14,674.65 | $29,842.45 | $40,916.19 |