- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,745.00 / $27,373.30 / $35,977.90
| Facility | | $18,745.00 | $27,373.30 | $35,977.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,117.80 / $15,117.80 / $19,349.43
| Facility | | $15,117.80 | $15,117.80 | $19,349.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,083.31 / $21,977.59 / $36,871.94
| Facility | | $8,083.31 | $21,977.59 | $36,871.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,729.98 / $27,621.64 / $49,269.20
| Facility | | $19,729.98 | $27,621.64 | $49,269.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,578.66 / $30,684.70 / $44,802.16
| Facility | | $23,578.66 | $30,684.70 | $44,802.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,578.66 / $28,525.52 / $44,802.16
| Facility | | $23,578.66 | $28,525.52 | $44,802.16 |