- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,630.10 / $26,386.20 / $46,432.10
| Facility | | $15,630.10 | $26,386.20 | $46,432.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,877.75 / $23,619.81 / $40,880.00
| Facility | | $15,877.75 | $23,619.81 | $40,880.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,298.88 / $28,729.82 / $47,238.56
| Facility | | $19,298.88 | $28,729.82 | $47,238.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,218.02 / $23,918.39 / $32,818.15
| Facility | | $14,218.02 | $23,918.39 | $32,818.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,187.40 / $51,187.40 / $60,072.76
| Facility | | $51,187.40 | $51,187.40 | $60,072.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $22,995.34 / $32,846.21
| Facility | | $1,787.00 | $22,995.34 | $32,846.21 |