- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,112.30 / $30,917.00 / $50,253.10
| Facility | | $18,112.30 | $30,917.00 | $50,253.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,932.34 / $27,932.34 / $27,932.34
| Facility | | $27,932.34 | $27,932.34 | $27,932.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,531.20 / $24,565.10 / $38,753.83
| Facility | | $15,531.20 | $24,565.10 | $38,753.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,320.74 / $26,011.88 / $49,417.99
| Facility | | $14,320.74 | $26,011.88 | $49,417.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,106.38 / $27,954.67 / $37,214.06
| Facility | | $18,106.38 | $27,954.67 | $37,214.06 |