- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,961.00 / $39,594.10 / $63,751.50
| Facility | | $12,961.00 | $39,594.10 | $63,751.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,496.89 / $16,496.89 / $16,496.89
| Facility | | $16,496.89 | $16,496.89 | $16,496.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $20,928.75 / $57,280.15
| Facility | | $1,474.01 | $20,928.75 | $57,280.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,661.02 / $41,398.16 / $58,645.47
| Facility | | $28,661.02 | $41,398.16 | $58,645.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,864.00 / $33,763.78 / $72,920.02
| Facility | | $20,864.00 | $33,763.78 | $72,920.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,864.00 / $33,763.78 / $62,599.28
| Facility | | $20,864.00 | $33,763.78 | $62,599.28 |