- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,280.34 / $8,963.00 / $26,357.70
| Facility | | $4,280.34 | $8,963.00 | $26,357.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,987.00 / $29,200.00 / $41,690.28
| Facility | | $9,987.00 | $29,200.00 | $41,690.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.00 / $22,000.00 / $22,000.00
| Facility | | $843.00 | $22,000.00 | $22,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,905.65 / $24,037.00 / $24,527.00
| Facility | | $22,905.65 | $24,037.00 | $24,527.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,079.76 / $16,079.76 / $16,079.76
| Facility | | $16,079.76 | $16,079.76 | $16,079.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,292.00 / $15,259.00 / $21,600.00
| Facility | | $9,292.00 | $15,259.00 | $21,600.00 |