- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,049.00 / $22,911.70 / $29,914.50
| Facility | | $11,049.00 | $22,911.70 | $29,914.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,652.86 / $56,027.97
| Facility | | $5,840.42 | $20,652.86 | $56,027.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,945.89 / $21,406.30 / $32,345.18
| Facility | | $12,945.89 | $21,406.30 | $32,345.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,399.15 / $30,399.15 / $30,399.15
| Facility | | $30,399.15 | $30,399.15 | $30,399.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,652.49 / $21,564.92 / $33,301.30
| Facility | | $18,652.49 | $21,564.92 | $33,301.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $20,652.86 / $56,027.97
| Facility | | $5,840.42 | $20,652.86 | $56,027.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $16,271.73 / $43,786.35
| Facility | | $5,840.42 | $16,271.73 | $43,786.35 |