- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,457.20 / $22,911.60 / $38,038.69
| Facility | | $14,457.20 | $22,911.60 | $38,038.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,805.75 / $35,805.75 / $40,266.08
| Facility | | $35,805.75 | $35,805.75 | $40,266.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,478.65 / $22,006.14 / $38,521.12
| Facility | | $12,478.65 | $22,006.14 | $38,521.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,963.00 / $24,437.86 / $34,992.04
| Facility | | $18,963.00 | $24,437.86 | $34,992.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,807.41 / $23,475.35 / $67,875.75
| Facility | | $11,807.41 | $23,475.35 | $67,875.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,807.41 / $23,424.28 / $32,921.67
| Facility | | $11,807.41 | $23,424.28 | $32,921.67 |