- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,617.59 / $22,706.70 / $46,146.00
| Facility | | $17,617.59 | $22,706.70 | $46,146.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,727.40 / $11,727.40 / $11,727.40
| Facility | | $11,727.40 | $11,727.40 | $11,727.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,650.59 / $22,125.40 / $25,295.05
| Facility | | $17,650.59 | $22,125.40 | $25,295.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,062.62 / $24,892.31 / $32,373.53
| Facility | | $14,062.62 | $24,892.31 | $32,373.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,486.51 / $13,486.51 / $32,210.27
| Facility | | $13,486.51 | $13,486.51 | $32,210.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $22,618.20 / $31,798.24
| Facility | | $1,518.00 | $22,618.20 | $31,798.24 |