- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,444.40 / $29,449.00 / $51,821.80
| Facility | | $17,444.40 | $29,449.00 | $51,821.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,885.83 / $38,885.83 / $38,885.83
| Facility | | $38,885.83 | $38,885.83 | $38,885.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,460.61 / $22,689.37 / $37,113.55
| Facility | | $15,460.61 | $22,689.37 | $37,113.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,868.41 / $26,694.78 / $36,627.61
| Facility | | $15,868.41 | $26,694.78 | $36,627.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,555.32 / $53,747.30 / $63,077.02
| Facility | | $25,555.32 | $53,747.30 | $63,077.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $25,664.58 / $36,658.92
| Facility | | $1,787.00 | $25,664.58 | $36,658.92 |