- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,415.09 / $19,458.00 / $32,852.90
| Facility | | $8,415.09 | $19,458.00 | $32,852.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,967.99 / $35,566.83 / $46,119.25
| Facility | | $23,967.99 | $35,566.83 | $46,119.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,397.53 / $27,662.02 / $40,717.41
| Facility | | $19,397.53 | $27,662.02 | $40,717.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,481.44 / $27,463.23 / $65,081.00
| Facility | | $15,481.44 | $27,463.23 | $65,081.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,945.29 / $12,945.29 / $12,945.29
| Facility | | $12,945.29 | $12,945.29 | $12,945.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,397.53 / $29,852.06 / $40,941.89
| Facility | | $19,397.53 | $29,852.06 | $40,941.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,619.74 / $25,541.22 / $42,815.00
| Facility | | $5,619.74 | $25,541.22 | $42,815.00 |