- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,786.20 / $31,758.10 / $45,923.00
| Facility | | $23,786.20 | $31,758.10 | $45,923.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,111.70 / $27,111.70 / $27,111.70
| Facility | | $27,111.70 | $27,111.70 | $27,111.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,076.14 / $28,688.25 / $42,975.36
| Facility | | $18,076.14 | $28,688.25 | $42,975.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,750.37 / $28,647.13 / $51,850.00
| Facility | | $20,750.37 | $28,647.13 | $51,850.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $155.55 / $295.73 / $484.20
| Facility | | $155.55 | $295.73 | $484.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,855.48 / $31,631.09 / $52,057.40
| Facility | | $22,855.48 | $31,631.09 | $52,057.40 |