- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,967.10 / $31,433.00 / $39,412.00
| Facility | | $12,967.10 | $31,433.00 | $39,412.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,180.32 / $13,551.05 / $22,253.68
| Facility | | $9,180.32 | $13,551.05 | $22,253.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,662.99 / $19,754.95 / $27,548.66
| Facility | | $11,662.99 | $19,754.95 | $27,548.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,286.25 / $39,286.25 / $46,105.75
| Facility | | $39,286.25 | $39,286.25 | $46,105.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $17,638.70 / $26,799.41
| Facility | | $2,520.00 | $17,638.70 | $26,799.41 |