- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,513.20 / $25,847.90 / $45,224.00
| Facility | | $19,513.20 | $25,847.90 | $45,224.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,477.00 / $21,700.00 / $44,106.46
| Facility | | $11,477.00 | $21,700.00 | $44,106.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $21,826.56 / $42,625.37
| Facility | | $5,939.30 | $21,826.56 | $42,625.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,715.23 / $24,798.91 / $40,377.15
| Facility | | $14,715.23 | $24,798.91 | $40,377.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $26,637.50 / $40,685.48
| Facility | | $3,496.00 | $26,637.50 | $40,685.48 |