- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,687.00 / $23,400.80 / $39,510.00
| Facility | | $10,687.00 | $23,400.80 | $39,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,842.19 / $35,380.16 / $45,877.18
| Facility | | $23,842.19 | $35,380.16 | $45,877.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,328.10 / $33,358.28 / $48,968.08
| Facility | | $23,328.10 | $33,358.28 | $48,968.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,166.16 / $32,985.19 / $69,170.99
| Facility | | $17,166.16 | $32,985.19 | $69,170.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,328.10 / $36,319.17 / $49,238.05
| Facility | | $23,328.10 | $36,319.17 | $49,238.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,758.48 / $30,716.70 / $46,177.12
| Facility | | $6,758.48 | $30,716.70 | $46,177.12 |