- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,737.00 / $23,495.10 / $41,107.50
| Facility | | $17,737.00 | $23,495.10 | $41,107.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,913.32 / $27,913.32 / $27,913.32
| Facility | | $27,913.32 | $27,913.32 | $27,913.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $20,285.06 / $39,944.97
| Facility | | $5,939.30 | $20,285.06 | $39,944.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,375.76 / $22,541.56 / $36,701.78
| Facility | | $13,375.76 | $22,541.56 | $36,701.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $20,203.03 / $36,982.04
| Facility | | $3,496.00 | $20,203.03 | $36,982.04 |