- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,757.00 / $18,469.90 / $30,398.30
| Facility | | $8,757.00 | $18,469.90 | $30,398.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,361.00 / $31,296.18 / $42,164.85
| Facility | | $21,361.00 | $31,296.18 | $42,164.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $24,395.07 / $39,005.15
| Facility | | $14,648.00 | $24,395.07 | $39,005.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,834.07 / $26,314.83 / $51,829.22
| Facility | | $14,834.07 | $26,314.83 | $51,829.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,030.56 / $10,030.56 / $10,030.56
| Facility | | $10,030.56 | $10,030.56 | $10,030.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $26,107.04 / $39,014.78
| Facility | | $17,646.00 | $26,107.04 | $39,014.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $18,267.68 / $36,389.82
| Facility | | $5,281.00 | $18,267.68 | $36,389.82 |