- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,738.10 / $26,165.60 / $34,247.00
| Facility | | $15,738.10 | $26,165.60 | $34,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,551.62 / $36,551.62 / $36,551.62
| Facility | | $36,551.62 | $36,551.62 | $36,551.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,532.81 / $23,286.76 / $35,279.94
| Facility | | $14,532.81 | $23,286.76 | $35,279.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,782.83 / $22,884.38 / $35,447.97
| Facility | | $14,782.83 | $22,884.38 | $35,447.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,454.25 / $21,992.85 / $33,546.04
| Facility | | $13,454.25 | $21,992.85 | $33,546.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $27,074.57 / $38,891.73
| Facility | | $10,403.00 | $27,074.57 | $38,891.73 |