- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,712.40 / $22,830.70 / $35,663.00
| Facility | | $13,712.40 | $22,830.70 | $35,663.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,448.41 / $20,448.41 / $20,448.41
| Facility | | $20,448.41 | $20,448.41 | $20,448.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,605.36 / $20,198.30 / $30,600.86
| Facility | | $12,605.36 | $20,198.30 | $30,600.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $18,067.18 / $30,118.57
| Facility | | $7,516.00 | $18,067.18 | $30,118.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $17,842.96 / $27,456.93
| Facility | | $7,516.00 | $17,842.96 | $27,456.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,089.86 / $23,623.85 / $33,214.93
| Facility | | $10,089.86 | $23,623.85 | $33,214.93 |