- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,410.80 / $24,327.80 / $42,810.00
| Facility | | $14,410.80 | $24,327.80 | $42,810.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,746.95 / $14,304.25 / $23,663.15
| Facility | | $9,746.95 | $14,304.25 | $23,663.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,732.97 / $22,052.54 / $30,570.94
| Facility | | $12,732.97 | $22,052.54 | $30,570.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,531.55 / $43,531.55 / $51,087.97
| Facility | | $43,531.55 | $43,531.55 | $51,087.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $21,201.50 / $30,283.91
| Facility | | $1,787.00 | $21,201.50 | $30,283.91 |