- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,650.10 / $24,158.20 / $31,541.90
| Facility | | $11,650.10 | $24,158.20 | $31,541.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.00 / $5,840.42 / $47,474.15
| Facility | | $708.00 | $5,840.42 | $47,474.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,650.17 / $22,570.85 / $34,104.82
| Facility | | $13,650.17 | $22,570.85 | $34,104.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,052.92 / $32,052.92 / $32,052.92
| Facility | | $32,052.92 | $32,052.92 | $32,052.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,667.22 / $22,738.09 / $35,112.96
| Facility | | $19,667.22 | $22,738.09 | $35,112.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.00 / $5,840.42 / $47,474.15
| Facility | | $708.00 | $5,840.42 | $47,474.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $708.00 / $3,775.00 / $25,956.08
| Facility | | $708.00 | $3,775.00 | $25,956.08 |