- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,805.00 / $17,549.70 / $31,647.50
| Facility | | $8,805.00 | $17,549.70 | $31,647.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,829.02 / $28,829.02 / $33,724.36
| Facility | | $28,829.02 | $28,829.02 | $33,724.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,441.00 / $21,575.40 / $33,611.17
| Facility | | $2,441.00 | $21,575.40 | $33,611.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,314.23 / $21,546.03 / $36,292.12
| Facility | | $12,314.23 | $21,546.03 | $36,292.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,150.00 / $17,093.88 / $38,321.26
| Facility | | $2,150.00 | $17,093.88 | $38,321.26 |