- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,240.00 / $23,314.80 / $28,152.00
| Facility | | $12,240.00 | $23,314.80 | $28,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,052.80 / $33,833.81
| Facility | | $6,916.00 | $21,052.80 | $33,833.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,933.80 / $19,609.96 / $23,512.66
| Facility | | $15,933.80 | $19,609.96 | $23,512.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,689.52 / $16,457.00 / $25,000.80
| Facility | | $10,689.52 | $16,457.00 | $25,000.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,618.42 / $20,660.56 / $32,372.47
| Facility | | $11,618.42 | $20,660.56 | $32,372.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,830.50 / $18,649.06 / $25,331.69
| Facility | | $12,830.50 | $18,649.06 | $25,331.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,196.24 / $27,652.61
| Facility | | $3,775.00 | $19,196.24 | $27,652.61 |