- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,137.00 / $25,553.80 / $44,967.30
| Facility | | $15,137.00 | $25,553.80 | $44,967.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,660.21 / $26,075.65 / $42,874.48
| Facility | | $17,660.21 | $26,075.65 | $42,874.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,769.50 / $23,163.86 / $31,865.31
| Facility | | $13,769.50 | $23,163.86 | $31,865.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,331.25 / $53,331.25 / $62,588.75
| Facility | | $53,331.25 | $53,331.25 | $62,588.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $22,269.93 / $31,810.05
| Facility | | $1,787.00 | $22,269.93 | $31,810.05 |