- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,903.70 / $27,605.00 / $36,282.40
| Facility | | $18,903.70 | $27,605.00 | $36,282.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,639.93 / $28,976.54 / $49,009.92
| Facility | | $10,639.93 | $28,976.54 | $49,009.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,896.98 / $27,855.43 / $50,580.71
| Facility | | $19,896.98 | $27,855.43 | $50,580.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,778.23 / $30,944.42 / $45,181.37
| Facility | | $23,778.23 | $30,944.42 | $45,181.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,778.23 / $28,766.96 / $45,181.37
| Facility | | $23,778.23 | $28,766.96 | $45,181.37 |