- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,285.40 / $24,711.00 / $41,722.10
| Facility | | $11,285.40 | $24,711.00 | $41,722.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,097.66 / $35,759.26 / $46,368.76
| Facility | | $24,097.66 | $35,759.26 | $46,368.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,634.24 / $35,226.01 / $51,709.80
| Facility | | $24,634.24 | $35,226.01 | $51,709.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,127.29 / $34,832.03 / $73,043.87
| Facility | | $18,127.29 | $34,832.03 | $73,043.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,634.24 / $38,352.68 / $51,994.88
| Facility | | $24,634.24 | $38,352.68 | $51,994.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,136.89 / $32,436.52 / $48,762.57
| Facility | | $7,136.89 | $32,436.52 | $48,762.57 |