- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,374.10 / $19,833.90 / $33,195.00
| Facility | | $14,374.10 | $19,833.90 | $33,195.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,656.35 / $32,656.35 / $32,656.35
| Facility | | $32,656.35 | $32,656.35 | $32,656.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,790.00 / $3,447.00 / $22,803.22
| Facility | | $1,790.00 | $3,447.00 | $22,803.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,711.76 / $22,314.05 / $37,420.51
| Facility | | $14,711.76 | $22,314.05 | $37,420.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $22,450.94 / $40,044.36
| Facility | | $3,775.00 | $22,450.94 | $40,044.36 |