- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,757.00 / $18,390.00 / $29,145.60
| Facility | | $8,757.00 | $18,390.00 | $29,145.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,460.25 / $30,126.78 / $38,725.55
| Facility | | $19,460.25 | $30,126.78 | $38,725.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $23,389.72 / $37,397.69
| Facility | | $14,648.00 | $23,389.72 | $37,397.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,113.31 / $25,197.53 / $52,840.03
| Facility | | $13,113.31 | $25,197.53 | $52,840.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,585.07 / $9,585.07 / $9,585.07
| Facility | | $9,585.07 | $9,585.07 | $9,585.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $25,031.14 / $37,406.93
| Facility | | $17,646.00 | $25,031.14 | $37,406.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,162.83 / $17,340.43 / $32,172.28
| Facility | | $5,162.83 | $17,340.43 | $32,172.28 |