- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,598.30 / $36,867.40 / $59,925.00
| Facility | | $21,598.30 | $36,867.40 | $59,925.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,607.00 / $23,704.69 / $43,433.87
| Facility | | $13,607.00 | $23,704.69 | $43,433.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,451.40 / $29,292.98 / $46,212.51
| Facility | | $18,451.40 | $29,292.98 | $46,212.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,570.96 / $25,245.71 / $46,660.04
| Facility | | $13,570.96 | $25,245.71 | $46,660.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,045.00 / $31,748.22 / $43,026.72
| Facility | | $20,045.00 | $31,748.22 | $43,026.72 |