- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,490.00 / $24,634.70 / $35,212.60
| Facility | | $15,490.00 | $24,634.70 | $35,212.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,668.29 / $23,668.29 / $24,701.70
| Facility | | $23,668.29 | $23,668.29 | $24,701.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,601.30 / $22,364.33 / $33,432.87
| Facility | | $14,601.30 | $22,364.33 | $33,432.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,096.04 / $22,221.55 / $40,220.00
| Facility | | $16,096.04 | $22,221.55 | $40,220.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $235.67 / $375.59
| Facility | | $150.00 | $235.67 | $375.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,728.98 / $24,536.21 / $40,380.87
| Facility | | $17,728.98 | $24,536.21 | $40,380.87 |