- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,817.70 / $26,579.30 / $34,703.00
| Facility | | $12,817.70 | $26,579.30 | $34,703.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,272.33 / $64,996.56
| Facility | | $5,840.42 | $24,272.33 | $64,996.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,018.18 / $24,832.89 / $37,522.79
| Facility | | $15,018.18 | $24,832.89 | $37,522.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,265.25 / $35,265.25 / $35,265.25
| Facility | | $35,265.25 | $35,265.25 | $35,265.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,638.26 / $25,016.90 / $38,631.96
| Facility | | $21,638.26 | $25,016.90 | $38,631.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,272.33 / $64,996.56
| Facility | | $5,840.42 | $24,272.33 | $64,996.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $24,272.33 / $50,795.39
| Facility | | $5,840.42 | $24,272.33 | $50,795.39 |