- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,757.00 / $18,612.00 / $31,466.40
| Facility | | $8,757.00 | $18,612.00 | $31,466.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,734.54 / $32,252.56 / $41,821.64
| Facility | | $21,734.54 | $32,252.56 | $41,821.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $25,252.24 / $40,375.67
| Facility | | $14,648.00 | $25,252.24 | $40,375.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,157.51 / $27,204.00 / $57,047.66
| Facility | | $14,157.51 | $27,204.00 | $57,047.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,086.53 / $10,507.90 / $10,714.19
| Facility | | $10,086.53 | $10,507.90 | $10,714.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $27,024.36 / $40,385.62
| Facility | | $17,646.00 | $27,024.36 | $40,385.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $18,581.66 / $34,734.15
| Facility | | $5,281.00 | $18,581.66 | $34,734.15 |