- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,579.05 / $24,978.50 / $41,470.10
| Facility | | $18,579.05 | $24,978.50 | $41,470.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,508.00 / $23,619.28 / $38,973.64
| Facility | | $13,508.00 | $23,619.28 | $38,973.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,154.24 / $22,701.95 / $38,457.58
| Facility | | $15,154.24 | $22,701.95 | $38,457.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,678.40 / $27,830.93 / $38,308.51
| Facility | | $21,678.40 | $27,830.93 | $38,308.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,872.56 / $25,593.07 / $67,763.78
| Facility | | $12,872.56 | $25,593.07 | $67,763.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,872.56 / $25,537.39 / $35,891.54
| Facility | | $12,872.56 | $25,537.39 | $35,891.54 |