- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,694.00 / $19,741.30 / $34,739.00
| Facility | | $11,694.00 | $19,741.30 | $34,739.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,992.06 / $21,648.97 / $35,319.23
| Facility | | $14,992.06 | $21,648.97 | $35,319.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,637.48 / $18,175.40 / $25,126.35
| Facility | | $10,637.48 | $18,175.40 | $25,126.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,974.50 / $37,974.50 / $44,566.30
| Facility | | $37,974.50 | $37,974.50 | $44,566.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $17,204.39 / $24,574.51
| Facility | | $1,787.00 | $17,204.39 | $24,574.51 |