- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,523.37 / $19,748.00 / $25,783.90
| Facility | | $9,523.37 | $19,748.00 | $25,783.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,801.09 / $48,291.55
| Facility | | $5,840.42 | $17,801.09 | $48,291.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,158.30 / $18,450.49 / $27,878.92
| Facility | | $11,158.30 | $18,450.49 | $27,878.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,201.60 / $26,201.60 / $26,201.60
| Facility | | $26,201.60 | $26,201.60 | $26,201.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,076.93 / $18,587.21 / $28,703.02
| Facility | | $16,076.93 | $18,587.21 | $28,703.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,801.09 / $48,291.55
| Facility | | $5,840.42 | $17,801.09 | $48,291.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,024.91 / $37,740.28
| Facility | | $5,840.42 | $14,024.91 | $37,740.28 |