- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,509.00 / $26,715.70 / $40,677.50
| Facility | | $17,509.00 | $26,715.70 | $40,677.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,532.94 / $35,532.94 / $35,532.94
| Facility | | $35,532.94 | $35,532.94 | $35,532.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,140.52 / $25,710.96 / $37,629.28
| Facility | | $16,140.52 | $25,710.96 | $37,629.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,594.09 / $25,670.26 / $46,462.00
| Facility | | $18,594.09 | $25,670.26 | $46,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $272.24 / $433.89
| Facility | | $150.00 | $272.24 | $433.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,480.45 / $28,344.14 / $46,647.85
| Facility | | $20,480.45 | $28,344.14 | $46,647.85 |