- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,927.40 / $26,586.00 / $26,586.00
| Facility | | $23,927.40 | $26,586.00 | $26,586.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,244.40 / $11,419.98 / $49,014.02
| Facility | | $10,244.40 | $11,419.98 | $49,014.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,198.99 / $17,018.52 / $44,016.99
| Facility | | $9,198.99 | $17,018.52 | $44,016.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,024.00 / $29,272.03 / $46,003.05
| Facility | | $16,024.00 | $29,272.03 | $46,003.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $39,718.81 / $51,283.64
| Facility | | $6,965.00 | $39,718.81 | $51,283.64 |