- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,036.00 / $25,573.80 / $35,144.30
| Facility | | $17,036.00 | $25,573.80 | $35,144.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,825.01 / $21,825.01 / $30,782.94
| Facility | | $21,825.01 | $21,825.01 | $30,782.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,575.93 / $24,958.21 / $37,812.23
| Facility | | $15,575.93 | $24,958.21 | $37,812.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,170.13 / $23,483.94 / $36,376.69
| Facility | | $15,170.13 | $23,483.94 | $36,376.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,806.75 / $22,569.06 / $34,424.94
| Facility | | $13,806.75 | $22,569.06 | $34,424.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $27,240.37 / $37,795.68
| Facility | | $10,403.00 | $27,240.37 | $37,795.68 |