- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,682.00 / $30,691.70 / $39,108.00
| Facility | | $19,682.00 | $30,691.70 | $39,108.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,631.81 / $21,631.81 / $21,631.81
| Facility | | $21,631.81 | $21,631.81 | $21,631.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,597.65 / $31,439.74 / $37,031.94
| Facility | | $17,597.65 | $31,439.74 | $37,031.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,752.28 / $31,884.87 / $44,668.37
| Facility | | $16,752.28 | $31,884.87 | $44,668.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,298.86 / $34,781.97 / $44,668.37
| Facility | | $30,298.86 | $34,781.97 | $44,668.37 |