- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,930.70 / $18,563.00 / $31,227.80
| Facility | | $8,930.70 | $18,563.00 | $31,227.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,434.55 / $31,807.40 / $41,244.40
| Facility | | $21,434.55 | $31,807.40 | $41,244.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $25,060.74 / $40,069.49
| Facility | | $14,648.00 | $25,060.74 | $40,069.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,050.15 / $26,997.71 / $56,615.05
| Facility | | $14,050.15 | $26,997.71 | $56,615.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,410.22 / $17,410.22 / $17,410.22
| Facility | | $17,410.22 | $17,410.22 | $17,410.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $26,819.42 / $40,079.37
| Facility | | $17,646.00 | $26,819.42 | $40,079.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $18,440.75 / $34,470.75
| Facility | | $5,281.00 | $18,440.75 | $34,470.75 |