- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,580.30 / $20,012.70 / $37,350.00
| Facility | | $15,580.30 | $20,012.70 | $37,350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,101.35 / $12,101.35 / $12,101.35
| Facility | | $12,101.35 | $12,101.35 | $12,101.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,602.33 / $17,761.32 / $30,799.97
| Facility | | $11,602.33 | $17,761.32 | $30,799.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,350.82 / $22,275.14 / $33,221.00
| Facility | | $17,350.82 | $22,275.14 | $33,221.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,302.85 / $20,484.00 / $51,881.02
| Facility | | $10,302.85 | $20,484.00 | $51,881.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,302.85 / $20,226.91 / $28,726.64
| Facility | | $10,302.85 | $20,226.91 | $28,726.64 |