- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,200.00 / $23,238.60 / $28,060.00
| Facility | | $12,200.00 | $23,238.60 | $28,060.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $20,984.00 / $36,019.28
| Facility | | $6,916.00 | $20,984.00 | $36,019.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,443.08 / $20,091.41 / $24,435.00
| Facility | | $17,443.08 | $20,091.41 | $24,435.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,294.14 / $20,514.45 / $26,627.71
| Facility | | $13,294.14 | $20,514.45 | $26,627.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,498.26 / $22,827.00 / $33,547.80
| Facility | | $12,498.26 | $22,827.00 | $33,547.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,201.04 / $19,147.53 / $27,267.40
| Facility | | $15,201.04 | $19,147.53 | $27,267.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,133.50 / $27,562.24
| Facility | | $3,775.00 | $19,133.50 | $27,562.24 |