- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,240.50 / $27,988.00 / $45,064.30
| Facility | | $12,240.50 | $27,988.00 | $45,064.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $14,787.91 / $36,878.98
| Facility | | $1,474.01 | $14,787.91 | $36,878.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,259.73 / $29,263.28 / $41,454.96
| Facility | | $20,259.73 | $29,263.28 | $41,454.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,709.23 / $24,543.92 / $51,545.27
| Facility | | $17,709.23 | $24,543.92 | $51,545.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,627.13 / $24,543.92 / $52,210.82
| Facility | | $16,627.13 | $24,543.92 | $52,210.82 |