- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,263.40 / $23,356.30 / $30,495.00
| Facility | | $11,263.40 | $23,356.30 | $30,495.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,329.11 / $57,115.19
| Facility | | $5,840.42 | $21,329.11 | $57,115.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,197.10 / $21,821.69 / $32,972.83
| Facility | | $13,197.10 | $21,821.69 | $32,972.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,989.05 / $30,989.05 / $30,989.05
| Facility | | $30,989.05 | $30,989.05 | $30,989.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,014.43 / $21,983.39 / $33,947.51
| Facility | | $19,014.43 | $21,983.39 | $33,947.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,329.11 / $57,115.19
| Facility | | $5,840.42 | $21,329.11 | $57,115.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,329.11 / $44,636.02
| Facility | | $5,840.42 | $21,329.11 | $44,636.02 |