- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,906.00 / $23,376.30 / $36,090.90
| Facility | | $15,906.00 | $23,376.30 | $36,090.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,468.41 / $28,468.41 / $28,468.41
| Facility | | $28,468.41 | $28,468.41 | $28,468.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,077.85 / $34,230.25 / $43,884.94
| Facility | | $24,077.85 | $34,230.25 | $43,884.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,901.68 / $34,611.23 / $43,497.67
| Facility | | $17,901.68 | $34,611.23 | $43,497.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,906.00 / $23,909.90 / $38,232.90
| Facility | | $15,906.00 | $23,909.90 | $38,232.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,601.93 / $31,809.53 / $48,327.92
| Facility | | $18,601.93 | $31,809.53 | $48,327.92 |