- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,120.00 / $5,868.00 / $34,973.30
| Facility | | $2,120.00 | $5,868.00 | $34,973.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,914.09 / $22,914.09 / $33,624.07
| Facility | | $22,914.09 | $22,914.09 | $33,624.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,558.11 / $22,185.64 / $35,963.16
| Facility | | $11,558.11 | $22,185.64 | $35,963.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,137.00 / $38,506.74 / $60,516.04
| Facility | | $22,137.00 | $38,506.74 | $60,516.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,609.00 / $44,199.18 / $67,462.53
| Facility | | $24,609.00 | $44,199.18 | $67,462.53 |