- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,791.10 / $22,182.60 / $38,443.69
| Facility | | $10,791.10 | $22,182.60 | $38,443.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,336.00 / $31,998.09 / $47,180.62
| Facility | | $19,336.00 | $31,998.09 | $47,180.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,071.04 / $32,990.69 / $48,428.49
| Facility | | $23,071.04 | $32,990.69 | $48,428.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,977.00 / $32,621.72 / $68,408.78
| Facility | | $16,977.00 | $32,621.72 | $68,408.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,071.04 / $35,918.96 / $48,695.48
| Facility | | $23,071.04 | $35,918.96 | $48,695.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,885.76 / $30,378.22 / $45,668.28
| Facility | | $5,885.76 | $30,378.22 | $45,668.28 |