- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,652.00 / $23,382.60 / $40,910.69
| Facility | | $17,652.00 | $23,382.60 | $40,910.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,122.47 / $27,122.47 / $27,122.47
| Facility | | $27,122.47 | $27,122.47 | $27,122.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $17,949.84 / $35,054.47
| Facility | | $5,939.30 | $17,949.84 | $35,054.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,255.71 / $22,433.64 / $36,526.05
| Facility | | $14,255.71 | $22,433.64 | $36,526.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $24,096.86 / $41,391.76
| Facility | | $3,496.00 | $24,096.86 | $41,391.76 |