- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,073.09 / $28,321.30 / $38,005.00
| Facility | | $17,073.09 | $28,321.30 | $38,005.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,957.54 / $20,957.54 / $20,957.54
| Facility | | $20,957.54 | $20,957.54 | $20,957.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,128.45 / $23,848.82 / $38,159.03
| Facility | | $14,128.45 | $23,848.82 | $38,159.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,019.28 / $22,803.00 / $52,296.40
| Facility | | $14,019.28 | $22,803.00 | $52,296.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,644.66 / $22,462.48 / $31,820.83
| Facility | | $16,644.66 | $22,462.48 | $31,820.83 |