- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,317.40 / $30,385.50 / $40,775.00
| Facility | | $18,317.40 | $30,385.50 | $40,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,605.02 / $24,899.65 / $29,619.70
| Facility | | $24,605.02 | $24,899.65 | $29,619.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,142.75 / $24,633.61 / $38,089.46
| Facility | | $14,142.75 | $24,633.61 | $38,089.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,041.08 / $24,465.00 / $56,108.03
| Facility | | $15,041.08 | $24,465.00 | $56,108.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,751.80 / $24,099.66 / $34,140.08
| Facility | | $17,751.80 | $24,099.66 | $34,140.08 |