- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,321.00 / $24,318.70 / $37,013.50
| Facility | | $3,321.00 | $24,318.70 | $37,013.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,713.75 / $23,048.73 / $31,429.66
| Facility | | $16,713.75 | $23,048.73 | $31,429.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,728.03 / $24,557.92 / $36,691.54
| Facility | | $15,728.03 | $24,557.92 | $36,691.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,613.89 / $24,340.80 / $43,924.08
| Facility | | $17,613.89 | $24,340.80 | $43,924.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $259.32 / $440.57
| Facility | | $150.00 | $259.32 | $440.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,912.24 / $26,482.79 / $42,799.98
| Facility | | $15,912.24 | $26,482.79 | $42,799.98 |