- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,487.00 / $30,666.80 / $41,152.50
| Facility | | $18,487.00 | $30,666.80 | $41,152.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,842.55 / $17,842.55 / $17,842.55
| Facility | | $17,842.55 | $17,842.55 | $17,842.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,104.54 / $25,877.08 / $41,404.32
| Facility | | $15,104.54 | $25,877.08 | $41,404.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,180.33 / $24,691.50 / $56,627.49
| Facility | | $15,180.33 | $24,691.50 | $56,627.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,023.15 / $24,322.77 / $34,456.17
| Facility | | $18,023.15 | $24,322.77 | $34,456.17 |