- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,757.00 / $18,563.00 / $30,324.50
| Facility | | $8,757.00 | $18,563.00 | $30,324.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,720.39 / $30,747.63 / $39,870.21
| Facility | | $20,720.39 | $30,747.63 | $39,870.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $24,335.80 / $38,910.37
| Facility | | $14,648.00 | $24,335.80 | $38,910.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,643.72 / $26,216.73 / $54,977.32
| Facility | | $13,643.72 | $26,216.73 | $54,977.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,798.47 / $10,798.47 / $10,798.47
| Facility | | $10,798.47 | $10,798.47 | $10,798.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $26,043.61 / $38,919.98
| Facility | | $17,646.00 | $26,043.61 | $38,919.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $18,031.00 / $33,473.60
| Facility | | $5,281.00 | $18,031.00 | $33,473.60 |