- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,683.60 / $36,041.00 / $54,066.00
| Facility | | $25,683.60 | $36,041.00 | $54,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,505.16 / $30,979.33 / $46,407.42
| Facility | | $19,505.16 | $30,979.33 | $46,407.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,405.60 / $30,932.27 / $55,986.00
| Facility | | $22,405.60 | $30,932.27 | $55,986.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $167.96 / $319.32 / $522.83
| Facility | | $167.96 | $319.32 | $522.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,678.63 / $34,154.26 / $56,209.94
| Facility | | $24,678.63 | $34,154.26 | $56,209.94 |