- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,156.00 / $16,877.00 / $27,284.90
| Facility | | $8,156.00 | $16,877.00 | $27,284.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,483.07 / $27,427.60 / $35,565.15
| Facility | | $18,483.07 | $27,427.60 | $35,565.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,647.00 / $21,896.52 / $35,010.23
| Facility | | $14,647.00 | $21,896.52 | $35,010.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,276.15 / $23,588.92 / $49,466.71
| Facility | | $12,276.15 | $23,588.92 | $49,466.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,317.82 / $23,433.15 / $35,018.87
| Facility | | $17,317.82 | $23,433.15 | $35,018.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,870.00 / $16,763.00 / $30,118.40
| Facility | | $4,870.00 | $16,763.00 | $30,118.40 |