- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,411.80 / $28,990.00 / $45,284.30
| Facility | | $17,411.80 | $28,990.00 | $45,284.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,961.49 / $7,961.49 / $20,509.83
| Facility | | $7,961.49 | $7,961.49 | $20,509.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,166.29 / $25,904.19 / $39,245.41
| Facility | | $16,166.29 | $25,904.19 | $39,245.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $22,941.40 / $39,274.43
| Facility | | $7,516.00 | $22,941.40 | $39,274.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.00 / $23,896.24 / $38,244.05
| Facility | | $7,516.00 | $23,896.24 | $38,244.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,312.50 / $29,997.16 / $42,663.83
| Facility | | $7,312.50 | $29,997.16 | $42,663.83 |