- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,978.48 / $17,470.00 / $29,496.40
| Facility | | $7,978.48 | $17,470.00 | $29,496.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,824.90 / $30,902.72 / $40,071.31
| Facility | | $20,824.90 | $30,902.72 | $40,071.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,415.75 / $22,709.00 / $36,557.44
| Facility | | $17,415.75 | $22,709.00 | $36,557.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,815.51 / $24,625.31 / $51,640.05
| Facility | | $12,815.51 | $24,625.31 | $51,640.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,531.05 / $22,709.00 / $36,557.44
| Facility | | $11,531.05 | $22,709.00 | $36,557.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $23,196.00 / $34,839.81
| Facility | | $5,281.00 | $23,196.00 | $34,839.81 |