- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,182.00 / $28,502.00 / $38,247.50
| Facility | | $17,182.00 | $28,502.00 | $38,247.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,872.93 / $23,872.93 / $23,872.93
| Facility | | $23,872.93 | $23,872.93 | $23,872.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,150.77 / $24,784.10 / $39,655.51
| Facility | | $14,150.77 | $24,784.10 | $39,655.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,108.74 / $22,948.50 / $52,630.09
| Facility | | $14,108.74 | $22,948.50 | $52,630.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,750.88 / $22,605.80 / $32,023.87
| Facility | | $16,750.88 | $22,605.80 | $32,023.87 |