- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,487.00 / $19,204.00 / $60,950.30
| Facility | | $3,487.00 | $19,204.00 | $60,950.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,246.00 / $29,747.60 / $34,978.73
| Facility | | $17,246.00 | $29,747.60 | $34,978.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,388.32 / $22,583.27 / $36,997.61
| Facility | | $15,388.32 | $22,583.27 | $36,997.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,588.00 / $29,939.45 / $43,079.64
| Facility | | $14,588.00 | $29,939.45 | $43,079.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,618.33 / $39,426.47 / $57,289.31
| Facility | | $33,618.33 | $39,426.47 | $57,289.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,791.00 / $12,896.00 / $41,569.75
| Facility | | $3,791.00 | $12,896.00 | $41,569.75 |