- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,458.90 / $30,620.30 / $41,090.00
| Facility | | $18,458.90 | $30,620.30 | $41,090.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,855.30 / $21,855.30 / $21,855.30
| Facility | | $21,855.30 | $21,855.30 | $21,855.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,298.14 / $26,793.62 / $42,870.82
| Facility | | $15,298.14 | $26,793.62 | $42,870.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,157.28 / $24,654.00 / $56,541.48
| Facility | | $15,157.28 | $24,654.00 | $56,541.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,871.10 / $23,539.64 / $34,116.21
| Facility | | $13,871.10 | $23,539.64 | $34,116.21 |