- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,590.00 / $19,590.00 / $23,218.00
| Facility | | $19,590.00 | $19,590.00 | $23,218.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,292.50 / $23,254.66 / $34,787.56
| Facility | | $14,292.50 | $23,254.66 | $34,787.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,022.21 / $19,830.87 / $33,739.93
| Facility | | $16,022.21 | $19,830.87 | $33,739.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,334.79 / $23,000.21 / $37,648.03
| Facility | | $14,334.79 | $23,000.21 | $37,648.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $210.25 / $13,269.46 / $19,210.91
| Facility | | $210.25 | $13,269.46 | $19,210.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,312.29 / $22,723.23 / $26,705.49
| Facility | | $16,312.29 | $22,723.23 | $26,705.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,721.84 / $24,237.65 / $30,553.53
| Facility | | $14,721.84 | $24,237.65 | $30,553.53 |