- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,303.80 / $29,649.70 / $42,919.00
| Facility | | $20,303.80 | $29,649.70 | $42,919.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,586.38 / $22,586.38 / $22,586.38
| Facility | | $22,586.38 | $22,586.38 | $22,586.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,844.45 / $32,519.53 / $54,558.21
| Facility | | $11,844.45 | $32,519.53 | $54,558.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,370.74 / $29,918.67 / $54,327.21
| Facility | | $21,370.74 | $29,918.67 | $54,327.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,539.48 / $33,236.46 / $48,527.94
| Facility | | $25,539.48 | $33,236.46 | $48,527.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,539.48 / $30,897.72 / $48,527.94
| Facility | | $25,539.48 | $30,897.72 | $48,527.94 |