- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.00 / $19,292.50 / $29,105.00
| Facility | | $3,182.00 | $19,292.50 | $29,105.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,865.59 / $17,237.29 / $23,966.38
| Facility | | $14,865.59 | $17,237.29 | $23,966.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.01 / $11,668.19 / $26,941.18
| Facility | | $1,474.01 | $11,668.19 | $26,941.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,427.92 / $19,106.43 / $28,575.44
| Facility | | $13,427.92 | $19,106.43 | $28,575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,461.29 / $20,299.00 / $35,530.82
| Facility | | $11,461.29 | $20,299.00 | $35,530.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,461.29 / $20,641.56 / $30,501.96
| Facility | | $11,461.29 | $20,641.56 | $30,501.96 |