- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,709.09 / $31,105.00 / $41,238.00
| Facility | | $18,709.09 | $31,105.00 | $41,238.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,495.63 / $32,495.63 / $32,495.63
| Facility | | $32,495.63 | $32,495.63 | $32,495.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,381.27 / $26,248.66 / $39,767.28
| Facility | | $16,381.27 | $26,248.66 | $39,767.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,573.47 / $27,204.41 / $42,139.71
| Facility | | $17,573.47 | $27,204.41 | $42,139.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,994.10 / $26,144.58 / $41,034.16
| Facility | | $15,994.10 | $26,144.58 | $41,034.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $32,185.61 / $46,233.57
| Facility | | $10,403.00 | $32,185.61 | $46,233.57 |