- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,247.70 / $18,988.00 / $33,413.30
| Facility | | $11,247.70 | $18,988.00 | $33,413.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,890.67 / $14,603.77 / $25,645.07
| Facility | | $9,890.67 | $14,603.77 | $25,645.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,231.53 / $17,502.25 / $24,167.48
| Facility | | $10,231.53 | $17,502.25 | $24,167.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,025.80 / $37,025.80 / $43,452.92
| Facility | | $37,025.80 | $37,025.80 | $43,452.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $16,547.84 / $23,636.70
| Facility | | $1,787.00 | $16,547.84 | $23,636.70 |