- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,793.80 / $24,456.10 / $31,930.90
| Facility | | $11,793.80 | $24,456.10 | $31,930.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,045.00 / $59,804.62
| Facility | | $5,840.42 | $22,045.00 | $59,804.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,818.52 / $22,849.23 / $34,525.46
| Facility | | $13,818.52 | $22,849.23 | $34,525.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,448.25 / $32,448.25 / $32,448.25
| Facility | | $32,448.25 | $32,448.25 | $32,448.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,909.79 / $23,018.54 / $35,546.03
| Facility | | $19,909.79 | $23,018.54 | $35,546.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,045.00 / $59,804.62
| Facility | | $5,840.42 | $22,045.00 | $59,804.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,368.55 / $46,737.84
| Facility | | $5,840.42 | $17,368.55 | $46,737.84 |