- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,494.80 / $23,996.30 / $38,637.00
| Facility | | $10,494.80 | $23,996.30 | $38,637.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,182.74 / $21,808.14 / $24,259.87
| Facility | | $21,182.74 | $21,808.14 | $24,259.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $13,092.59 / $34,007.33
| Facility | | $1,474.01 | $13,092.59 | $34,007.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,370.21 / $25,089.64 / $35,542.49
| Facility | | $17,370.21 | $25,089.64 | $35,542.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,183.47 / $21,043.37 / $44,193.68
| Facility | | $15,183.47 | $21,043.37 | $44,193.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,255.70 / $21,043.37 / $44,764.31
| Facility | | $14,255.70 | $21,043.37 | $44,764.31 |