- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,157.00 / $24,157.00 / $28,630.90
| Facility | | $24,157.00 | $24,157.00 | $28,630.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,420.28 / $29,970.79 / $44,834.47
| Facility | | $18,420.28 | $29,970.79 | $44,834.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,757.48 / $24,454.07 / $41,605.76
| Facility | | $19,757.48 | $24,454.07 | $41,605.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,676.68 / $28,362.28 / $46,424.96
| Facility | | $17,676.68 | $28,362.28 | $46,424.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $270.97 / $17,101.78 / $24,434.33
| Facility | | $270.97 | $17,101.78 | $24,434.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,115.20 / $28,020.72 / $32,931.37
| Facility | | $20,115.20 | $28,020.72 | $32,931.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,153.96 / $29,888.20 / $37,676.51
| Facility | | $18,153.96 | $29,888.20 | $37,676.51 |