- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,629.20 / $20,569.20 / $31,702.10
| Facility | | $12,629.20 | $20,569.20 | $31,702.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,036.68 / $19,036.68 / $19,036.68
| Facility | | $19,036.68 | $19,036.68 | $19,036.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,383.62 / $17,588.53 / $40,488.73
| Facility | | $14,383.62 | $17,588.53 | $40,488.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $14,949.54 / $30,001.31
| Facility | | $100.00 | $14,949.54 | $30,001.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,708.96 / $20,571.39 / $35,996.18
| Facility | | $13,708.96 | $20,571.39 | $35,996.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,233.68 / $27,928.35 / $32,776.29
| Facility | | $19,233.68 | $27,928.35 | $32,776.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,630.67 / $17,357.87 / $36,310.14
| Facility | | $12,630.67 | $17,357.87 | $36,310.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,693.00 / $15,887.61 / $32,526.25
| Facility | | $5,693.00 | $15,887.61 | $32,526.25 |