- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,012.00 / $31,036.70 / $47,633.40
| Facility | | $3,012.00 | $31,036.70 | $47,633.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,059.28 / $31,947.54 / $47,996.37
| Facility | | $20,059.28 | $31,947.54 | $47,996.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,983.70 / $31,905.77 / $57,314.89
| Facility | | $22,983.70 | $31,905.77 | $57,314.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.24 / $333.78 / $581.15
| Facility | | $173.24 | $333.78 | $581.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,500.00 / $33,947.16 / $54,799.96
| Facility | | $22,500.00 | $33,947.16 | $54,799.96 |