- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,941.40 / $37,453.10 / $60,877.00
| Facility | | $21,941.40 | $37,453.10 | $60,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,056.74 / $34,056.74 / $34,056.74
| Facility | | $34,056.74 | $34,056.74 | $34,056.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,814.59 / $29,758.32 / $46,946.63
| Facility | | $18,814.59 | $29,758.32 | $46,946.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,406.83 / $29,828.40 / $58,261.69
| Facility | | $15,406.83 | $29,828.40 | $58,261.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,804.80 / $33,864.47 / $45,081.34
| Facility | | $21,804.80 | $33,864.47 | $45,081.34 |