- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,057.50 / $20,625.70 / $36,462.00
| Facility | | $16,057.50 | $20,625.70 | $36,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,529.69 / $13,529.69 / $13,529.69
| Facility | | $13,529.69 | $13,529.69 | $13,529.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,971.77 / $19,857.71 / $33,094.61
| Facility | | $12,971.77 | $19,857.71 | $33,094.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,760.39 / $21,977.03 / $32,010.00
| Facility | | $17,760.39 | $21,977.03 | $32,010.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,618.43 / $22,063.59 / $58,004.61
| Facility | | $10,618.43 | $22,063.59 | $58,004.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,618.43 / $21,065.51 / $29,606.54
| Facility | | $10,618.43 | $21,065.51 | $29,606.54 |