- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,533.00 / $25,533.00 / $30,261.70
| Facility | | $25,533.00 | $25,533.00 | $30,261.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,456.24 / $30,029.30 / $44,922.00
| Facility | | $18,456.24 | $30,029.30 | $44,922.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,882.86 / $25,846.96 / $43,975.61
| Facility | | $20,882.86 | $25,846.96 | $43,975.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,683.54 / $29,977.78 / $49,069.31
| Facility | | $18,683.54 | $29,977.78 | $49,069.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $271.50 / $17,135.16 / $25,038.93
| Facility | | $271.50 | $17,135.16 | $25,038.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,260.95 / $29,616.78 / $34,807.14
| Facility | | $21,260.95 | $29,616.78 | $34,807.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,188.00 / $31,590.62 / $39,822.55
| Facility | | $19,188.00 | $31,590.62 | $39,822.55 |