- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,114.80 / $26,453.00 / $34,768.30
| Facility | | $18,114.80 | $26,453.00 | $34,768.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,333.75 / $20,333.75 / $20,333.75
| Facility | | $20,333.75 | $20,333.75 | $20,333.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,508.54 / $17,725.20 / $29,979.79
| Facility | | $6,508.54 | $17,725.20 | $29,979.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,402.16 / $26,570.56 / $44,473.12
| Facility | | $18,402.16 | $26,570.56 | $44,473.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,785.96 / $29,653.10 / $43,295.94
| Facility | | $22,785.96 | $29,653.10 | $43,295.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,785.96 / $27,566.51 / $43,295.94
| Facility | | $22,785.96 | $27,566.51 | $43,295.94 |