- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,001.00 / $21,815.20 / $36,218.40
| Facility | | $17,001.00 | $21,815.20 | $36,218.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,260.02 / $18,471.34 / $25,368.73
| Facility | | $12,260.02 | $18,471.34 | $25,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,434.27 / $20,565.74 / $34,092.74
| Facility | | $13,434.27 | $20,565.74 | $34,092.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,804.00 / $23,846.33 / $35,913.00
| Facility | | $18,804.00 | $23,846.33 | $35,913.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,242.37 / $22,351.96 / $60,072.76
| Facility | | $11,242.37 | $22,351.96 | $60,072.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,242.37 / $22,303.33 / $31,346.23
| Facility | | $11,242.37 | $22,303.33 | $31,346.23 |