- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,692.40 / $22,172.30 / $28,949.00
| Facility | | $10,692.40 | $22,172.30 | $28,949.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,986.32 / $54,219.75
| Facility | | $5,840.42 | $19,986.32 | $54,219.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,528.08 / $20,715.45 / $31,301.29
| Facility | | $12,528.08 | $20,715.45 | $31,301.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,418.07 / $29,418.07 / $29,418.07
| Facility | | $29,418.07 | $29,418.07 | $29,418.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,050.50 / $20,868.95 / $32,226.56
| Facility | | $18,050.50 | $20,868.95 | $32,226.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,986.32 / $54,219.75
| Facility | | $5,840.42 | $19,986.32 | $54,219.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,746.58 / $42,373.22
| Facility | | $5,840.42 | $15,746.58 | $42,373.22 |