- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,799.10 / $24,467.00 / $31,945.20
| Facility | | $11,799.10 | $24,467.00 | $31,945.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,054.84 / $59,831.32
| Facility | | $5,840.42 | $22,054.84 | $59,831.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,824.69 / $22,859.43 / $34,540.87
| Facility | | $13,824.69 | $22,859.43 | $34,540.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,462.74 / $32,462.74 / $32,462.74
| Facility | | $32,462.74 | $32,462.74 | $32,462.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,918.68 / $23,028.82 / $35,561.90
| Facility | | $19,918.68 | $23,028.82 | $35,561.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $22,054.84 / $59,831.32
| Facility | | $5,840.42 | $22,054.84 | $59,831.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $17,376.30 / $46,758.71
| Facility | | $5,840.42 | $17,376.30 | $46,758.71 |