- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,717.84 / $25,303.00 / $40,506.30
| Facility | | $16,717.84 | $25,303.00 | $40,506.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,420.62 / $24,420.62 / $24,420.62
| Facility | | $24,420.62 | $24,420.62 | $24,420.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,916.34 / $21,235.90 / $30,136.16
| Facility | | $10,916.34 | $21,235.90 | $30,136.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,066.71 / $20,184.96 / $35,366.74
| Facility | | $15,066.71 | $20,184.96 | $35,366.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,794.29 / $23,195.00 / $31,303.56
| Facility | | $14,794.29 | $23,195.00 | $31,303.56 |